Provider Demographics
NPI:1255433819
Name:HERRINGTON, RYAN DOUGLASS (MD MPH)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:DOUGLASS
Last Name:HERRINGTON
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 MARTIN WAY E STE 105
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-5317
Mailing Address - Country:US
Mailing Address - Phone:614-256-5071
Mailing Address - Fax:
Practice Address - Street 1:203 4TH AVE E STE 501
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1190
Practice Address - Country:US
Practice Address - Phone:614-256-5071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA607361382083P0901X
WAMD607361382083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1018047Medicaid
VT1018047Medicaid