Provider Demographics
NPI:1861505380
Name:SWEET, RYAN JAMES (DC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:JAMES
Last Name:SWEET
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9016 LITTLEROCK RD SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-8535
Mailing Address - Country:US
Mailing Address - Phone:360-357-8763
Mailing Address - Fax:
Practice Address - Street 1:4704 PACIFIC AVE SE STE B
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1200
Practice Address - Country:US
Practice Address - Phone:360-438-6001
Practice Address - Fax:360-438-0606
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA192226OtherLABOR AND INDUSTRIES