Provider Demographics
NPI:1699392548
Name:RYAN WATHNE PLLC
Entity Type:Organization
Organization Name:RYAN WATHNE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WATHNE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:206-941-5728
Mailing Address - Street 1:825 LEGION WAY SE STE 3B
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1586
Mailing Address - Country:US
Mailing Address - Phone:206-941-5728
Mailing Address - Fax:
Practice Address - Street 1:825 LEGION WAY SE STE 3B
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1586
Practice Address - Country:US
Practice Address - Phone:206-941-5728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1255972063OtherNPPES INDIVIDUAL NPI