Provider Demographics
NPI:1245267939
Name:UNGER, RICHARD J (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:UNGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:723 MEMORIAL ST
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-1524
Mailing Address - Country:US
Mailing Address - Phone:509-786-2222
Mailing Address - Fax:509-786-6612
Practice Address - Street 1:820 MEMORIAL ST STE 3
Practice Address - Street 2:
Practice Address - City:PROSSER
Practice Address - State:WA
Practice Address - Zip Code:99350-2504
Practice Address - Country:US
Practice Address - Phone:509-786-5599
Practice Address - Fax:509-788-0488
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-02867208600000X
WI25208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAE64947Medicare UPIN
IAI18070Medicare PIN