Individual
DR. RYAN BUSHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
919 N PINES RD, SPOKANE VALLEY, WA 99206
(509) 924-0381
Mailing address
919 N PINES RD, SPOKANE VALLEY, WA 99206-4932
(509) 924-0381
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60855064
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
153536142
AMERICAN DENTAL ASSOCIATION
—
05
—
2102572
—
WA
01
—
DE60855064
WA STATE DEPARTMENT OF HEALTH
WA
Enumeration date
05/04/2018
Last updated
09/26/2019
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