Individual
MARY KATHRYN RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, ATL
Contact information
Practice address
4011 TALBOT RD S STE 300, RENTON, WA 98055-5791
(425) 656-5060
(425) 656-5047
Mailing address
4011 TALBOT RD S STE 300, RENTON, WA 98055-5791
(425) 656-5060
(425) 656-5047
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2601001845
MI
363AS0400X
Surgical Physician Assistant
Primary
PA61227531
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2193228
—
WA
Enumeration date
02/05/2014
Last updated
10/26/2021
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