Provider Demographics
NPI:1841543659
Name:RYER, THALIA MARIE (MA, LMFTA)
Entity type:Individual
Prefix:
First Name:THALIA
Middle Name:MARIE
Last Name:RYER
Suffix:
Gender:F
Credentials:MA, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7981 168TH AVE NE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-0911
Mailing Address - Country:US
Mailing Address - Phone:425-202-5897
Mailing Address - Fax:
Practice Address - Street 1:7981 168TH AVE NE
Practice Address - Street 2:SUITE 220
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-0911
Practice Address - Country:US
Practice Address - Phone:425-202-5897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG 60301916101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health