Provider Demographics
NPI:1205963147
Name:RICH, DONALD M III (MS, ATC)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:M
Last Name:RICH
Suffix:III
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10724 SLATER AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033
Mailing Address - Country:US
Mailing Address - Phone:425-893-5149
Mailing Address - Fax:425-893-5153
Practice Address - Street 1:10724 SLATER AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-4607
Practice Address - Country:US
Practice Address - Phone:425-893-5149
Practice Address - Fax:425-893-5153
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer