Individual
RYAN THOMAS PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
5729 181ST PL SW, LYNNWOOD, WA 98037-7312
(509) 290-9067
Mailing address
5729 181ST PL SW, LYNNWOOD, WA 98037-7312
(509) 290-9067
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60552083
WA
363L00000X
Nurse Practitioner
Primary
AP61196922
WA
363LF0000X
Family Nurse Practitioner
F06211579
WA
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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