Most Relevant Information
Provider Data
| NPI Number: | 1003647405 |
| Provider Name: | RYAN TACKETT |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/08/2024 |
| Last Updated: | 08/08/2024 |
Provider Practice Location
929 N 130TH ST
SEATTLE
WA
981337500
Practice Location Phone/Fax
| Phone: | 2538337444 |
| Fax: |
Provider Mailing Location
325 W GOWE ST
KENT
WA
980325892
Provider Mailing Phone/Fax
| Phone: | 2538337444 |
| Fax: |