Individual
NICHOLLE RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 SE BLAIRMONT DR, VANCOUVER, WA 98683-8331
(360) 604-6100
Mailing address
200 SW FLORENCE AVE APT H19, GRESHAM, OR 97080-7171
(406) 570-1073
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60759122
WA
Other
Enumeration date
08/20/2017
Last updated
08/20/2017
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