Individual
RICKARD D. ANTLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
406 YAUGER WAY SW STE A, OLYMPIA, WA 98502-8151
(360) 352-3901
(360) 754-9866
Mailing address
1909 14TH AVE SW, OLYMPIA, WA 98502-5705
(360) 946-5547
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10003134
WA
Other
Enumeration date
02/15/2006
Last updated
09/13/2012
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