Provider Demographics
NPI:1669681268
Name:RICHARDSON, STEVEN K (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:K
Last Name:RICHARDSON
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 1:104 W 5TH AVE STE 400W
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4880
Mailing Address - Country:US
Mailing Address - Phone:509-353-3960
Mailing Address - Fax:509-343-0134
Practice Address - Street 1:104 W 5TH AVE
Practice Address - Street 2:SUITE 400W
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4880
Practice Address - Country:US
Practice Address - Phone:509-353-3960
Practice Address - Fax:509-343-0134
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60026895207R00000X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1092435Medicaid
WA1092435Medicaid