Provider Demographics
NPI:1225581176
Name:RYAN HANKS
Entity Type:Organization
Organization Name:RYAN HANKS
Other - Org Name:NW FAMILY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-981-4950
Mailing Address - Street 1:27081 185TH AVE SE
Mailing Address - Street 2:B105
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-8448
Mailing Address - Country:US
Mailing Address - Phone:253-981-4950
Mailing Address - Fax:253-981-4952
Practice Address - Street 1:27081 185TH AVE SE
Practice Address - Street 2:B105
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-8448
Practice Address - Country:US
Practice Address - Phone:253-981-4950
Practice Address - Fax:253-981-4952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty