Individual
RYAN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1007 KOALA DR, OMAK, WA 98841-9247
(509) 826-6191
(509) 826-3029
Mailing address
1007 KOALA DR, OMAK, WA 98841-9247
(509) 826-6191
(509) 826-3029
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/19/2017
Last updated
12/19/2017
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