Provider Demographics
NPI:1164673794
Name:RIBARY, JAMES L
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:RIBARY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7108 PIONEER WAY STE E
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1178
Mailing Address - Country:US
Mailing Address - Phone:253-858-8158
Mailing Address - Fax:
Practice Address - Street 1:7108 PIONEER WAY STE E
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1178
Practice Address - Country:US
Practice Address - Phone:253-858-8158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA46651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5514609Medicaid