Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003387762 |
---|---|
Provider Name | Aidan Clyde Rygaard |
First Address | Port Angeles, WA 98362-6129 |
Second Address | Port Angeles, WA 98362-6129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2018 |
Last Update Date | 06/12/2018 |