Individual
RYAN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
861 GRANT AVE, BLAINE, WA 98230-5186
(360) 371-5855
(360) 371-5857
Mailing address
861 GRANT AVE, BLAINE, WA 98230-5186
(360) 371-5855
(360) 371-5857
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95034813
CA
363LF0000X
Family Nurse Practitioner
Primary
AP61395684
WA
363LF0000X
Family Nurse Practitioner
F357288-01
NY
Other
Enumeration date
01/16/2023
Last updated
01/14/2026
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