Provider Demographics
NPI:1427554179
Name:GUILFOILE, FORREST RYAN (MD)
Entity type:Individual
Prefix:
First Name:FORREST
Middle Name:RYAN
Last Name:GUILFOILE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 S 12TH AVE STE 4B
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3137
Mailing Address - Country:US
Mailing Address - Phone:509-575-8457
Mailing Address - Fax:509-453-1273
Practice Address - Street 1:307 S 12TH AVE STE 4B
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3137
Practice Address - Country:US
Practice Address - Phone:509-575-8457
Practice Address - Fax:509-453-1273
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN658542084P0800X
MN291512084P0800X
WAMD614038732084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1427554179Medicaid