Smith, Ryan Lee

Smith, Ryan Lee is an individual health care provider with primary practice located at 109 E Harrison Ave , Coeur D Alene ID 83814-3238. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Smith, Ryan Lee can be contacted via phone (208) 292-0281.

Contact Information

Primary practice address
109 E Harrison Ave Coeur D Alene ID 83814-3238
Phone: (208) 292-0281
Fax: (844) 807-3877
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA-840 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA-840 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-840 Idaho

Profile Details

NPI number 1053633297
LBN Legal business name Smith, Ryan Lee
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2010
Last updated Oct 14th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053633297 NPPES
Idaho MEDICAID 1053633297

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