Provider Demographics
NPI:1508854696
Name:STEIN, RICHARD E (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:STEIN
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 1:16122 8TH AVE SW
Mailing Address - Street 2:SUITE E3
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2967
Mailing Address - Country:US
Mailing Address - Phone:206-431-9771
Mailing Address - Fax:206-431-5484
Practice Address - Street 1:16122 8TH AVE SW
Practice Address - Street 2:SUITE E3
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2967
Practice Address - Country:US
Practice Address - Phone:206-431-9771
Practice Address - Fax:206-431-5484
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00024018207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7094170Medicaid
WAST3456OtherREGENCE PROV #
WA1039882Medicaid
WA0131326OtherGRP L&I #
WA08315OtherIND L&I #
WA2218089OtherAETNA
WAGAB08939Medicare ID - Type UnspecifiedINDIV ID
WAST3456OtherREGENCE PROV #
WA1039882Medicaid