Provider Demographics
NPI:1497958359
Name:CANAAN, RICHARD NEY (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:NEY
Last Name:CANAAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 EAST FIFTH STREET
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362
Mailing Address - Country:US
Mailing Address - Phone:360-457-6985
Mailing Address - Fax:360-457-6985
Practice Address - Street 1:909 GEORGLANEE STREET
Practice Address - Street 2:VIMO CLINIC
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-4709
Practice Address - Country:US
Practice Address - Phone:360-457-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00032574207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery