Individual
RYAN MOREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
207 PHYSICAL EDUCATION BUILDING, EASTERN WASHINGTON UNIVERSITY ATHLETICS, CHENEY, WA 99004-2476
(906) 281-4757
Mailing address
1090 W BETZ RD, APARTMENT 30212, CHENEY, WA 99004-8400
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
2255A2300X
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
SPECIALIST/TECHNOLOGIST - ATHLETIC TRAINER
WA
Enumeration date
10/05/2016
Last updated
10/05/2016
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