Provider Demographics
NPI:1831192459
Name:STERN, RYAN B (DPT)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:B
Last Name:STERN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2532 W FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-7012
Mailing Address - Country:US
Mailing Address - Phone:509-465-4799
Mailing Address - Fax:509-343-3022
Practice Address - Street 1:2532 W FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-7012
Practice Address - Country:US
Practice Address - Phone:509-465-4799
Practice Address - Fax:509-343-3022
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8334229Medicaid
WAAB24740Medicare ID - Type Unspecified
WAP41589Medicare UPIN