Individual
RYAN NICHOLS M.DIV., SUDP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDP
Contact information
Practice address
1800 112TH AVE NE, BELLEVUE, WA 98004-2993
(425) 698-1515
Mailing address
1800 112TH AVE NE, BELLEVUE, WA 98004-2993
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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