Walter, Jack Ryan
Walter, Jack Ryan is an individual health care provider with primary practice located at 9040 Jackson Ave Mamc Urology , Tacoma WA 98431. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Walter, Jack Ryan can be contacted via phone (253) 968-2300.Contact Information
Primary practice address
9040 Jackson Ave Mamc Urology
Tacoma WA 98431
Phone: (253) 968-2300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MD60267047 | Washington |
Profile Details
| NPI number | 1306879366 |
|---|---|
| LBN Legal business name | Walter, Jack Ryan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 9th, 2006 |
| Last updated | Feb 12th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306879366 | NPPES |
| Washington | MEDICAID | 1306879366 | |
| Washington | Other | P01715983 |
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