Seattle Nad Pllc | |
15144 Se 46th Way Bellevue WA 98006-3229 | |
(206) 695-2707 | |
(801) 701-8387 |
Full Name | Seattle Nad Pllc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 15144 Se 46th Way, Bellevue, Washington |
Authorized Official Name and Position | Richard Eduardo Repass (OWNER) |
Authorized Official Contact | 9524176773 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Seattle Nad Pllc Po Box 1775 Mercer Island WA 98040-1775 Ph: (952) 417-6773 | Seattle Nad Pllc 15144 Se 46th Way Bellevue WA 98006-3229 Ph: (206) 695-2707 |
NPI Number | 1790552636 |
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Provider Enumeration Date | 12/11/2023 |
Last Update Date | 12/26/2024 |
Certification Date | 12/26/2024 |
Medicare PECOS PAC ID | 6305384009 |
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Medicare Enrollment ID | O20240813001924 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790552636 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Secondary |
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Richard Repass |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1316085855 PECOS PAC ID: 7719058270 Enrollment ID: I20190626000985 |
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