Provider Demographics
NPI:1588084537
Name:LEMKE, RYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:LEMKE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 N 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-6702
Mailing Address - Country:US
Mailing Address - Phone:206-856-5126
Mailing Address - Fax:206-632-3638
Practice Address - Street 1:1628 N 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6702
Practice Address - Country:US
Practice Address - Phone:206-632-3638
Practice Address - Fax:206-632-3638
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA606344841223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty