Individual
TIMOTHY RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
(253) 620-5015
Mailing address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00043693
WA
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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