Active NPI
Ryan Warren Anderson
- Counselor
- Fife, WA
National Provider Identifier
1003496548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG61146480
- Practice address
- 2150 Freeman Rd E
Fife, WA 98424-3776 - Phone
- (253) 922-7833
- NPI assigned
- Apr 9, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG61146480 | WA | Primary |
Addresses
Primary practice location
2150 Freeman Rd E
Fife, WA 98424-3776
Mailing address
2701 N 16TH St Ste 316
Phoenix, AZ 85006-1266
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG61146480 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617926400000",
"number": "1003496548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 N 16TH ST STE 316",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850061266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2150 FREEMAN RD E",
"city": "FIFE",
"state": "WA",
"postal_code": "984243776",
"telephone_number": "253-922-7833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "RYAN",
"middle_name": "WARREN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-09",
"last_updated": "2021-04-09",
"certification_date": "2021-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG61146480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fife, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.