Individual
RYAN DUANE TOLLACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
222 WALL ST, SEATTLE, WA 98121-1431
(206) 441-3043
Mailing address
222 WALL ST, SEATTLE, WA 98121-1431
(206) 441-3043
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
WA
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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