Individual
MR. RYAN J MATHER
Active
Individual
MR. RYAN J MATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10004291
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0159543
L & I
WA
01
—
G8861207
MEDICARE POSM
WA
01
—
G8876711
MEDICARE EMRI
WA
Enumeration date
06/19/2006
Last updated
05/15/2012
Update your record
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