| Doctor Name: | MR. JOHN MICHAEL RICHARDS |
| NPI Number: | 1013057215 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | N.P. |
| License Number: | 000038332N3 |
| Business Practice Address: | 703 Se 1st Ave Canby, OR - 970133849 |
| Business Phone Number: | 5032667686 |
| Business Fax Number: | 5032667382 |
| Mailing Address: | 703 Se 1st Ave, CANBY |
| State: | OR |
| Postal Code: | 970133849 |
| Phone Number: | 5032667686 |
| Fax Number: | 5032667382 |
| NPI Enumeration Date: | 02/07/2007 |
| NPI Last Update Date: | 12/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 000038332N3 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |