Provider Demographics
NPI:1386462588
Name:RICHTER, NATHAN DAVID (LSWAIC)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:DAVID
Last Name:RICHTER
Suffix:
Gender:M
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S JACKSON ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2883
Mailing Address - Country:US
Mailing Address - Phone:612-444-1618
Mailing Address - Fax:
Practice Address - Street 1:108 S JACKSON ST STE 203
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2883
Practice Address - Country:US
Practice Address - Phone:612-444-1618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61272172104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker