Provider Demographics
NPI:1326938184
Name:HENESEY, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:HENESEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 JEANNETTE PL NW
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1655
Mailing Address - Country:US
Mailing Address - Phone:425-466-9290
Mailing Address - Fax:
Practice Address - Street 1:490 MADISON AVE N STE 101
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1871
Practice Address - Country:US
Practice Address - Phone:425-466-9290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist