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Individual

ADAM RYAN MAXWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
305 S PACIFIC AVE, SUITE 102, KELSO, WA 98626
(360) 423-0203
(360) 423-5068
Mailing address
PO BOX 1847, LONGVIEW, WA 98632-8140
(360) 423-0203
(360) 577-0187

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
390200000X
Student in an Organized Health Care Education/Training Program
Primary
WA

Other

Enumeration date
09/26/2022
Last updated
09/26/2022
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