Provider Demographics
NPI:1457761314
Name:BROOKS, RICHARD PAUL JR (ARNP)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:PAUL
Last Name:BROOKS
Suffix:JR
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 LEVEE ST
Mailing Address - Street 2:
Mailing Address - City:HOQUIAM
Mailing Address - State:WA
Mailing Address - Zip Code:98550-2527
Mailing Address - Country:US
Mailing Address - Phone:360-532-0060
Mailing Address - Fax:360-532-0061
Practice Address - Street 1:804 LEVEE ST
Practice Address - Street 2:
Practice Address - City:HOQUIAM
Practice Address - State:WA
Practice Address - Zip Code:98550-2527
Practice Address - Country:US
Practice Address - Phone:360-532-0060
Practice Address - Fax:360-532-0061
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-01
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60466102363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health