Provider Demographics
NPI:1689032005
Name:PHILLIPS, RICHARD CLAUDE (MD, MS, MPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:CLAUDE
Last Name:PHILLIPS
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Gender:M
Credentials:MD, MS, MPH
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Mailing Address - Street 1:51 W DAYTON ST
Mailing Address - Street 2:SUITE #305
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-4111
Mailing Address - Country:US
Mailing Address - Phone:425-670-1560
Mailing Address - Fax:425-361-1512
Practice Address - Street 1:51 W DAYTON ST
Practice Address - Street 2:SUITE #305
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-4111
Practice Address - Country:US
Practice Address - Phone:425-670-1560
Practice Address - Fax:425-361-1512
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-30
Last Update Date:2016-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA00020821208D00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice