Provider Demographics
NPI:1982456372
Name:RICHARDS, CASEY A (PRS)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:A
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SW NAITO PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-3512
Mailing Address - Country:US
Mailing Address - Phone:907-531-9961
Mailing Address - Fax:
Practice Address - Street 1:111 SW NAITO PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-3512
Practice Address - Country:US
Practice Address - Phone:888-288-4715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist