Organization
RYAN BUSHMAN DMD & CHASE DAVIS DDS PLLC
Active
Other names
Medical Lake Dental
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLIE RIVERSON (BILLING CREDENTIALING MANAGER)
(509) 924-0381
Entity
Organization
Contact information
Practice address
123 N BROWER ST, MEDICAL LAKE, WA 99022-5109
(509) 299-5171
Mailing address
1222 N PINES RD STE 101, SPOKANE VALLEY, WA 99206-4939
(509) 924-0381
(509) 893-9485
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/30/2022
Last updated
04/18/2022
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