Provider Demographics
NPI:1689147159
Name:RYAN MCNAMARA DDS PLLC
Entity Type:Organization
Organization Name:RYAN MCNAMARA DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-898-4604
Mailing Address - Street 1:15965 NE 85TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3593
Mailing Address - Country:US
Mailing Address - Phone:425-898-4604
Mailing Address - Fax:425-898-4570
Practice Address - Street 1:15965 NE 85TH ST STE 100
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3593
Practice Address - Country:US
Practice Address - Phone:425-898-4604
Practice Address - Fax:425-898-4570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty