Provider Demographics
NPI:1588795199
Name:SIMPSON, RYAN MICHAEL (ATC)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:MICHAEL
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23606 65TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-7421
Mailing Address - Country:US
Mailing Address - Phone:253-847-2428
Mailing Address - Fax:
Practice Address - Street 1:23606 65TH AVENUE CT E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-7421
Practice Address - Country:US
Practice Address - Phone:253-847-2428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer