# RYAN A. GILBRETH

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

## Provider details

- **NPI number:** 1962805226
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | 5857 | AZ | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | PA60938311 | WA | — |
| 363A00000X | Physician Assistant | 5857 | AZ | — |
| 363A00000X | Physician Assistant | PA60938311 | WA | Yes |

## Other

- **Enumeration date:** 10/01/2014
- **Last updated:** 08/22/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0406945 | LNI-RADIA REST OF WA | WA |
| 01 | — | 0406946 | LNI-RADIA KING COUNTY | WA |
| 01 | — | 0406947 | LNI-SWEDISH RADIA EDMONDS | WA |
| 01 | — | 0406948 | LNI-EVERGREEN RADIA | WA |
| 01 | — | 0406949 | LNI-SOUTH SOUND RADIOLOGY | WA |
| 01 | — | 0406950 | LNI-SEATTLE RADIOLOGY | WA |
| 05 | — | 2128654 | — | WA |
| 05 | — | 981176 | — | AZ |