Provider Demographics
NPI:1730222837
Name:A HEALTHY RISK, INC.
Entity type:Organization
Organization Name:A HEALTHY RISK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:CDP
Authorized Official - Phone:360-249-2297
Mailing Address - Street 1:315 W MARCY AVE
Mailing Address - Street 2:
Mailing Address - City:MONTESANO
Mailing Address - State:WA
Mailing Address - Zip Code:98563-3618
Mailing Address - Country:US
Mailing Address - Phone:360-249-2297
Mailing Address - Fax:360-249-2298
Practice Address - Street 1:315 W MARCY AVE
Practice Address - Street 2:
Practice Address - City:MONTESANO
Practice Address - State:WA
Practice Address - Zip Code:98563-3618
Practice Address - Country:US
Practice Address - Phone:360-249-2297
Practice Address - Fax:360-249-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA14 0737 00261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder