Individual
LAURA A RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
32014 LITTLE BOSTON RD NE, KINGSTON, WA 98346-9734
(360) 297-9601
(360) 297-9614
Mailing address
32014 LITTLE BOSTON RD NE, KINGSTON, WA 98346-9734
(360) 297-9601
(360) 297-9614
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10004074
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01677227
L&I ID#
WA
01
—
5163RY
REGENCE RIDER#
WA
05
—
8350498
—
WA
01
—
910875163-38
KPS ID#
WA
Enumeration date
08/24/2006
Last updated
07/08/2007
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