Individual
DR. DAVID MICHAEL RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1410 N PITTSBURG ST, BLDG. A, KENNEWICK, WA 99336-8211
(509) 374-4166
(509) 374-4167
Mailing address
1410 N PITTSBURGH ST, BLDG. A, KENNEWICK, WA 99336-8211
(509) 374-4166
(509) 374-4167
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20A5788
CA
207Q00000X
Family Medicine Physician
Primary
OP00001368
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7128952
—
WA
01
—
GAB29419
MEDICARE PTAN
WA
Enumeration date
08/11/2006
Last updated
06/29/2010
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