Individual
CARTER RICHARD PRIBNOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1323 128TH ST NW, TULALIP, WA 98271-7020
(406) 465-8688
Mailing address
1323 128TH ST NW, TULALIP, WA 98271-7020
(406) 465-8688
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
WDL1526CB13B
WA
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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