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Organization
SKYLAND RANCH
Active
Organization
SKYLAND RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE SPEAKS (BUSINESS ASSISTANT)
(425) 772-0707
Entity
Organization
Contact information
Practice address
43100 REITER RD, GOLD BAR, WA 98251
(360) 793-2611
Mailing address
43100 REITER RD, GOLD BAR, WA 98251
(360) 793-2611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
207QA0505X
Adult Medicine Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
12/15/2025
Last updated
12/15/2025
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