Provider Demographics
NPI:1790552636
Name:SEATTLE NAD PLLC
Entity type:Organization
Organization Name:SEATTLE NAD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:REPASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-417-6773
Mailing Address - Street 1:PO BOX 1775
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-1775
Mailing Address - Country:US
Mailing Address - Phone:952-417-6773
Mailing Address - Fax:801-701-8387
Practice Address - Street 1:15144 SE 46TH WAY
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-3229
Practice Address - Country:US
Practice Address - Phone:206-695-2707
Practice Address - Fax:801-701-8387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty