Provider Demographics
NPI:1427220847
Name:NYGAARD, RITA M (LMHC)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:M
Last Name:NYGAARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8404 27TH ST W
Mailing Address - Street 2:
Mailing Address - City:UNIV PL
Mailing Address - State:WA
Mailing Address - Zip Code:98466
Mailing Address - Country:US
Mailing Address - Phone:253-564-2765
Mailing Address - Fax:
Practice Address - Street 1:8404 27TH ST W
Practice Address - Street 2:
Practice Address - City:UNIV PL
Practice Address - State:WA
Practice Address - Zip Code:98466
Practice Address - Country:US
Practice Address - Phone:253-564-2765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004613101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WANY5539RIDEROtherREGENCE HEALTH INS