Provider Demographics
NPI:1881713907
Name:MANN, RICHARD (ND)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:MANN
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15455 SE 47TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-3268
Mailing Address - Country:US
Mailing Address - Phone:206-261-0505
Mailing Address - Fax:206-261-0505
Practice Address - Street 1:229 BROADWAY E
Practice Address - Street 2:SUITE 19
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-5787
Practice Address - Country:US
Practice Address - Phone:206-325-6935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000548175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5915535OtherAETNA PROVDER ID
WAMA0572OtherREGENCE BLUE SHIELD RIDER