Provider Demographics
NPI:1588249916
Name:PHILLIPS, RYAN E (ND, MPH, BCB, CHES)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:E
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:ND, MPH, BCB, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 S YOSEMITE ST STE 260
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2005
Mailing Address - Country:US
Mailing Address - Phone:720-893-8950
Mailing Address - Fax:720-542-3310
Practice Address - Street 1:7000 S YOSEMITE ST STE 260
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2005
Practice Address - Country:US
Practice Address - Phone:720-893-8950
Practice Address - Fax:720-542-3310
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO175F00000X
CO000213175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath