Individual
JEANNA TACHIKI RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
243 E 6100 S, MURRAY, UT 84107-7302
(801) 414-8890
Mailing address
2330 E CAPRICE CT, HOLLADAY, UT 84124-6800
(801) 414-8890
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
87742931206
UT
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/07/2014
Last updated
11/17/2021
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