Bryan, Roberta D.

Bryan, Roberta D. is an individual health care provider with primary practice located at 1956 Ne Kresky Ave , Chehalis WA 98532-2307. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Bryan, Roberta D. can be contacted via phone (360) 740-4380.

Contact Information

Primary practice address
1956 Ne Kresky Ave Chehalis WA 98532-2307
Phone: (360) 740-4380
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X CG60505628 Washington
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CP60956223 Washington

Profile Details

NPI number 1871054973
LBN Legal business name Bryan, Roberta D.
Credentials SUDP, AAC, CPC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2019
Last updated May 4th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871054973 NPPES
Washington MEDICAID 2130811

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