Provider Demographics
NPI:1285011510
Name:CONRAD SPECIALTY CONSULTING COMPANY
Entity Type:Organization
Organization Name:CONRAD SPECIALTY CONSULTING COMPANY
Other - Org Name:STEVEN R. CONRAD AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED COUNSELOR
Authorized Official - Phone:360-727-6558
Mailing Address - Street 1:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-0251
Mailing Address - Country:US
Mailing Address - Phone:360-727-6558
Mailing Address - Fax:
Practice Address - Street 1:1504 S 21ST PL
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-8017
Practice Address - Country:US
Practice Address - Phone:360-727-6558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACL 60302224251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health