Individual
RYAN R IWAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6801
Mailing address
1100 OLIVE WAY MSC M4-PA, SEATTLE, WA 98101-1873
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30001338
WA
Other
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
Enumeration date
02/02/2007
Last updated
05/10/2010
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