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Individual

RYAN A. GILBRETH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1501
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
5857
AZ
2085R0204X
Vascular & Interventional Radiology Physician
PA60938311
WA
363A00000X
Physician Assistant
5857
AZ
363A00000X
Physician Assistant
Primary
PA60938311
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0406945
LNI-RADIA REST OF WA
WA
01
0406946
LNI-RADIA KING COUNTY
WA
01
0406947
LNI-SWEDISH RADIA EDMONDS
WA
01
0406948
LNI-EVERGREEN RADIA
WA
01
0406949
LNI-SOUTH SOUND RADIOLOGY
WA
01
0406950
LNI-SEATTLE RADIOLOGY
WA
05
2128654
WA
05
981176
AZ
Enumeration date
10/01/2014
Last updated
08/22/2019
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