Basic Information
| Provider Information | |||||||||
| NPI: | 1184627564 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RITCHIE | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12040 NE 128TH ST # 69 | ||||||||
| Address2: | |||||||||
| City: | KIRKLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980343013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4258993455 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 12040 NE 128TH ST # 69 | ||||||||
| Address2: | |||||||||
| City: | KIRKLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980343013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4258993455 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2005 | ||||||||
| LastUpdateDate: | 11/26/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD60636225 | WA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 2003-0470 | NM | N | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 797813 | 05 | AZ | MEDICAID | 1184627564 | 05 | WA | MEDICAID | 80926 | 05 | NM | MEDICAID | 925207 | 01 | NM | PRONET / AETNA | OTHER | 30576555 | 05 | NM | MEDICAID | NM009L48 | 01 | NM | BLUE CROSS BLUE SHEILD | OTHER |