Individual
JASPER ELIJAH RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
748 MARKET ST # 157, TACOMA, WA 98402-3737
(253) 778-1017
Mailing address
810 S 14TH ST APT 114, TACOMA, WA 98405-5002
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61525877
WA
Other
Enumeration date
04/15/2025
Last updated
04/15/2025
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