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Individual

JOHANNA RIDDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1300 O AVE, ANACORTES, WA 98221-2187
(360) 419-4699
Mailing address
2305 HIGHLAND DR, ANACORTES, WA 98221-3143
(360) 293-7137

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
P160259921
WA

Other

Enumeration date
06/05/2016
Last updated
06/05/2016
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