Provider Demographics
NPI:1164417101
Name:BIERMAN, RYAN ALAN (DPM)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:ALAN
Last Name:BIERMAN
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 1:2728 E MAIN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3198
Mailing Address - Country:US
Mailing Address - Phone:253-841-2006
Mailing Address - Fax:253-840-6691
Practice Address - Street 1:17700 SE 272ND ST
Practice Address - Street 2:SUITE 370
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4951
Practice Address - Country:US
Practice Address - Phone:253-631-0585
Practice Address - Fax:253-631-0596
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000712213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7109770Medicaid
WA8281297Medicaid
WA7109770Medicaid
WAGAB25239Medicare PIN
WA8281297Medicaid
WAG8906838Medicare PIN
WAG8906903Medicare PIN