Individual
DR. RYAN MICHAEL FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
747 BROADWAY, SEATTLE, WA 98122-4379
(206) 215-2700
(206) 215-2702
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD61449691
WA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD61449691
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2260168
—
WA
Enumeration date
05/29/2014
Last updated
10/05/2023
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