Provider Demographics
NPI:1174597009
Name:MATTHIES, RICH J (MD)
Entity type:Individual
Prefix:DR
First Name:RICH
Middle Name:J
Last Name:MATTHIES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4746
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W
Practice Address - Street 2:SUITE 210
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4746
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1501
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00021639174400000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2240480OtherAETNA
WA109456OtherL&I
300065977OtherRAILROAD MEDICARE
WA8140568Medicaid
WA8919498OtherCRIME VICTIMS
WA351153OtherL&I-RADIA REST OF WA
WA1004137Medicaid
WA351175OtherL&I-EVERGREEN RADIA
WAMA1945OtherREGENCE
WA351165OtherL&I-RADIA KING COUNTY
WA351172OtherL&I-SWEDISH RADIA
WAMA1945OtherREGENCE
WAP01623657Medicare PIN
WAP01623670Medicare PIN
WAP01623679Medicare PIN
WA109456OtherL&I
WA351175OtherL&I-EVERGREEN RADIA
2240480OtherAETNA
WA351172OtherL&I-SWEDISH RADIA
WA1004137Medicaid