Provider Demographics
NPI:1124565908
Name:RHOADS, NATHAN (LHMCA)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:RHOADS
Suffix:
Gender:M
Credentials:LHMCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 SYLVAN DR W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PL
Mailing Address - State:WA
Mailing Address - Zip Code:98466-2740
Mailing Address - Country:US
Mailing Address - Phone:253-652-0964
Mailing Address - Fax:
Practice Address - Street 1:2701 SYLVAN DR W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PL
Practice Address - State:WA
Practice Address - Zip Code:98466-2740
Practice Address - Country:US
Practice Address - Phone:253-652-0964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-31
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60682862101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health