Provider Demographics
NPI:1003293069
Name:RICHTER, LIANE MF (ARNP)
Entity type:Individual
Prefix:
First Name:LIANE
Middle Name:MF
Last Name:RICHTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LIANE
Other - Middle Name:
Other - Last Name:FERNYHOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 34876
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1876
Mailing Address - Country:US
Mailing Address - Phone:425-656-5412
Mailing Address - Fax:
Practice Address - Street 1:123 BROADWAY E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-5711
Practice Address - Country:US
Practice Address - Phone:206-465-0316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2299273163W00000X
WAAP60686042363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse