Individual
CHELEACE RYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 205-8011
Mailing address
321 W H ST, SHELTON, WA 98584-2913
(360) 229-8140
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60720114
WA
Other
Enumeration date
04/01/2021
Last updated
04/01/2021
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