Individual
RYAN FREDERICK HOLBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 S SHERMAN ST, SPOKANE, WA 99202-1311
(509) 228-1000
(509) 252-9300
Mailing address
PO BOX 3868, SPOKANE, WA 99220-3868
(509) 228-1000
(509) 252-9300
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
MD00032407
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010138943
BLUE SHIELD OF IDAHO
—
05
—
000570500
—
ID
01
—
0161842
DEPT OF LABOR & INDUSTRIE
—
05
—
1093673
—
WA
01
—
4581883
AETNA
—
01
—
910000377
RAILROAD MEDICARE
—
01
—
HO2112
ASURIS NORTHWEST HEALTH
—
01
—
KR827
BLUE CROSS OF IDAHO
—
Enumeration date
10/14/2005
Last updated
03/27/2017
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