Provider Demographics
NPI:1619332657
Name:HILTON, RICHARD GLRN (CDPT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:GLRN
Last Name:HILTON
Suffix:
Gender:M
Credentials:CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7714 196TH ST SW
Mailing Address - Street 2:APT # 205
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-6538
Mailing Address - Country:US
Mailing Address - Phone:425-246-9560
Mailing Address - Fax:
Practice Address - Street 1:17018 15TH AVE NE
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-5126
Practice Address - Country:US
Practice Address - Phone:206-362-7282
Practice Address - Fax:206-362-7152
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)