Individual
CONNIE L RYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
9873 BRIDGEPORT WAY SW, LAKEWOOD, WA 98499-2895
(206) 883-7799
Mailing address
2509 S 13TH ST, TACOMA, WA 98405-2621
(206) 883-7799
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA00007372
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
602050322
DEPARTMENT OF LICENSING (UBI)
WA
Enumeration date
04/13/2010
Last updated
04/13/2010
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