Individual
MR. NICHOLAS WIARDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
4001 N COOK ST, SPOKANE, WA 99207-5879
(509) 483-3427
(509) 482-5064
Mailing address
PO BOX 190, TOPPENISH, WA 98948-0190
(509) 865-2395
(509) 865-0757
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LH60495122
WA
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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