| David M Ryan, D.o. | |
|
1410 N Pittsburg St Ste A Kennewick WA 99336-8211 | |
| (509) 374-4166 | |
| (509) 374-4167 |
| Full Name | David M Ryan, D.o. |
|---|---|
| Speciality | Family Medicine |
| Location | 1410 N Pittsburg St Ste A, Kennewick, Washington |
| Authorized Official Name and Position | David Michael Ryan (OWNER) |
| Authorized Official Contact | 5093744166 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David M Ryan, D.o. 1410 N Pittsburg St Ste A Kennewick WA 99336-8211 Ph: (509) 374-4166 | David M Ryan, D.o. 1410 N Pittsburg St Ste A Kennewick WA 99336-8211 Ph: (509) 374-4166 |
| NPI Number | 1619034980 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 02/23/2011 |
| Medicare PECOS PAC ID | 2466348792 |
|---|---|
| Medicare Enrollment ID | O20040224001085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619034980 | NPI | - | NPPES |
| 7128952 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OP00001368 (Washington) | Primary |
| Provider Name | David Michael Ryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912918129 PECOS PAC ID: 7719873041 Enrollment ID: I20101119000305 |
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