Oxana P Ryder, LMP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA60129815 Issued in WA

Practice address

10809 211TH Avenue CT E
Bonney Lake, WA 98391-6656

Phone

(206) 407-5602

NPI assigned

Mar 9, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Oxana Petrovna Ryder Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1598088247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10809 211TH AVENUE CT E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916656",
            "telephone_number": "206-407-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10809 211TH AVENUE CT E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916656",
            "telephone_number": "206-407-5602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15324 Main St E Ste B",
            "address_purpose": "LOCATION",
            "city": "Sumner",
            "state": "WA",
            "postal_code": "983902698",
            "country_code": "US",
            "telephone_number": "253-863-5323",
            "fax_number": "253-863-2034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYDER",
        "first_name": "OXANA",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60129815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OXANA",
            "last_name": "RYDER",
            "middle_name": "PETROVNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Specialist in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.