Provider Demographics
NPI:1588218549
Name:LOFLAND, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:LOFLAND
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 1:1848 NW SIERRA WAY
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7251
Mailing Address - Country:US
Mailing Address - Phone:316-518-9770
Mailing Address - Fax:
Practice Address - Street 1:1848 NW SIERRA WAY
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7251
Practice Address - Country:US
Practice Address - Phone:316-518-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60979145111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor