Provider Demographics
NPI:1396896551
Name:RICHTER, CHRISTINE HALL (OD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:HALL
Last Name:RICHTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19116 33RD W AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101
Mailing Address - Country:US
Mailing Address - Phone:425-712-7900
Mailing Address - Fax:
Practice Address - Street 1:19116 33RD W AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:425-712-7900
Practice Address - Fax:425-712-7905
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003090152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1334HAOtherBLUE SHIELD #
WA2016376Medicaid
WA0039597OtherLABOR AND INDUSTRIES #
WA410044098OtherRAILROAD MEDICARE
WAUS2343168OtherAETNA SPECIALIST PIN
U50441Medicare UPIN
WA410044098OtherRAILROAD MEDICARE
WA2016376Medicaid