Provider Demographics
NPI:1073140083
Name:STONE, RYAN JEFFREY (DPM)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JEFFREY
Last Name:STONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16233 SYLVESTER RD SW STE G10
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3069
Mailing Address - Country:US
Mailing Address - Phone:206-242-6553
Mailing Address - Fax:206-246-0468
Practice Address - Street 1:16233 SYLVESTER RD SW STE G10
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3069
Practice Address - Country:US
Practice Address - Phone:206-242-6553
Practice Address - Fax:206-246-0468
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO61393847213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2255079Medicaid