Individual provider Active NPI

Ryan Douglass Herrington, MD MPH

  • Addiction Medicine (Preventive Medicine) Physician
  • Olympia, WA
National Provider Identifier
1255433819
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
License
MD60736138 Issued in WA
Practice address
203 4TH Ave E Ste 501
Olympia, WA 98501-1190
Phone
(614) 256-5071
NPI assigned
Sep 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 60736138 WA
Addiction Medicine (Preventive Medicine) Physician 2083A0300X MD60736138 WA Primary

Addresses

Primary practice location

203 4TH Ave E Ste 501
Olympia, WA 98501-1190

Mailing address

4250 Martin Way E Ste 105
Olympia, WA 98516-5317
Phone (614) 256-5071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 2, 2023 through Apr 2, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60736138WAMDAddiction Medicine (Preventive Medicine) Physician
60736138WAMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pro-Active Wound Care Clinics LLC Past Accepting new patients
Clearchoicemd Primary Care PLLC Past Accepting new patients
Wedgewood Urgent Care, LTD PastSince Feb 1, 2002 Accepting new patients
Northwestern Medical Center, Inc. PastSince Jan 11, 2016 Accepting new patients
Immediate Health Associates Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1255433819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 MARTIN WAY E STE 105",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985165317",
            "telephone_number": "614-256-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 4TH AVE E STE 501",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011190",
            "telephone_number": "614-256-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRINGTON",
        "first_name": "RYAN",
        "middle_name": "DOUGLASS",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-03",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "WA",
            "license": "60736138",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "WA",
            "license": "MD60736138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.