Provider Demographics
NPI:1578528519
Name:BILLINGHAM, RICHARD PARKER (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:PARKER
Last Name:BILLINGHAM
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 1:1101 MADISON ST STE 500
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3557
Mailing Address - Country:US
Mailing Address - Phone:206-386-6600
Mailing Address - Fax:206-386-2452
Practice Address - Street 1:1101 MADISON ST STE 500
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3557
Practice Address - Country:US
Practice Address - Phone:206-386-6600
Practice Address - Fax:206-386-2452
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00013877208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA280000288Medicare PIN
WA000100464Medicare PIN
A04082Medicare UPIN