Provider Demographics
NPI:1356605257
Name:RICHARD L AGRESS MD
Entity type:Organization
Organization Name:RICHARD L AGRESS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:AGRESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-899-3339
Mailing Address - Street 1:801 BROADWAY
Mailing Address - Street 2:SUITE 628
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4396
Mailing Address - Country:US
Mailing Address - Phone:425-892-3999
Mailing Address - Fax:
Practice Address - Street 1:801 BROADWAY
Practice Address - Street 2:SUITE 628
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4396
Practice Address - Country:US
Practice Address - Phone:425-892-3999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty