Provider Demographics
NPI:1194006460
Name:RYDLAND, MORGAN LEE
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:LEE
Last Name:RYDLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3821 14TH AVE W
Mailing Address - Street 2:UNIT C307
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-1369
Mailing Address - Country:US
Mailing Address - Phone:360-870-3267
Mailing Address - Fax:
Practice Address - Street 1:3821 14TH AVE W
Practice Address - Street 2:UNIT C307
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-1369
Practice Address - Country:US
Practice Address - Phone:360-870-3267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490167921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical