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NPI Code Detail

MEDICARE: RYAN CUDDY CO 61009527

MEDICARE: RYAN CUDDY CO 61009527
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCO61009527WA
2101YM0800XMental Health CounselorMC70079479WA

General Provider Information

NPI Number : 1326661752
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN CUDDY CO 61009527
Provider Business Mailing Address
First Line : 1622 E MARINE VIEW DR APT J403
Second Line :
City : EVERETT
State : WA
Zip : 98201-2271
Country : US
Telephone Number : 425-310-2019
Fax Number :
Provider Business Practice Location Address
First Line : 6330 31ST AVE NE STE 101
Second Line :
City : TULALIP
State : WA
Zip : 98271-7423
Country : US
Telephone Number : 360-716-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2020
Last Update Date : 03/16/2026

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Directions to “ RYAN CUDDY CO 61009527” Practice Location

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