Provider Demographics
NPI:1700475274
Name:BROWN, RYAN TYLER (DC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:TYLER
Last Name:BROWN
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 1:5834 PIONEER RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-9086
Mailing Address - Country:US
Mailing Address - Phone:360-920-7585
Mailing Address - Fax:
Practice Address - Street 1:21 BELLWETHER WAY STE 101
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2961
Practice Address - Country:US
Practice Address - Phone:360-502-7548
Practice Address - Fax:360-797-8647
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61130303111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor