Provider Demographics
NPI:1689683583
Name:RICE, DONALD E (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:RICE
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 1:17311 135TH AVE NE
Mailing Address - Street 2:STE C100
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-3518
Mailing Address - Country:US
Mailing Address - Phone:425-825-7917
Mailing Address - Fax:425-424-3544
Practice Address - Street 1:830 6TH ST S
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6714
Practice Address - Country:US
Practice Address - Phone:425-825-7917
Practice Address - Fax:425-424-3544
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000130832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1719905Medicaid
WA8853531Medicare PIN
WAG8877619Medicare PIN
WA000104468Medicare ID - Type Unspecified
WA1719905Medicaid