# RYAN R IWAMOTO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1407994486
- **Gender:** Man
- **Credential:** ARNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | AP30001338 | WA | Yes |

## Other

- **Enumeration date:** 02/02/2007
- **Last updated:** 05/10/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0039573 | LABOR AND INDUSTRIES\# | WA |
| 01 | — | 8890564 | MERICARE PTAN - SNO CO | WA |
| 05 | — | 9662222 | — | WA |
| 01 | — | US0863919 | AETNA SPECIALIST PIN | WA |