Provider Demographics
NPI:1194725630
Name:GARCIA, RICHARD A (MSW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 W POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2831
Mailing Address - Country:US
Mailing Address - Phone:509-525-0572
Mailing Address - Fax:509-525-0576
Practice Address - Street 1:408 W POPLAR ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2831
Practice Address - Country:US
Practice Address - Phone:509-525-0572
Practice Address - Fax:509-525-0576
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005137101YM0800X
WALW000048201041C0700X
WALF00000902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB08174Medicare ID - Type Unspecified