Provider Demographics
NPI:1295889335
Name:GILES, RICHARD WILLIAM (BC-HIS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:WILLIAM
Last Name:GILES
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6132 BROADVIEW LN
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-6900
Mailing Address - Country:US
Mailing Address - Phone:360-690-4327
Mailing Address - Fax:360-690-0043
Practice Address - Street 1:8317 E MILL PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-2006
Practice Address - Country:US
Practice Address - Phone:360-690-4327
Practice Address - Fax:360-690-0043
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-647063237700000X
WAHA00000347237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2130657Medicaid
WA356890201OtherUS DEPT OF LABOR
WA131329OtherDEPT LABOR & INDUSTRIES
WA47-0898696OtherEIN