NPIMap

Individual provider Active NPI

Ryan Patrick Bredeweg, M.D.

  • Vascular & Interventional Radiology Physician
  • Tacoma, WA
National Provider Identifier
1639382302
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD60149277 Issued in WA
Practice address
1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone
(253) 761-4200
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD60149277 WA
Student in an Organized Health Care Education/Training Program 390200000X 4301088522 MI
Vascular & Interventional Radiology Physician 2085R0204X MD60149277 WA Primary

Addresses

Primary practice location

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900

Mailing address

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone (253) 761-4200

Other practice location 1

1304 Fawcett Ave
Suite 100
Tacoma, WA 98402-1911
Phone (253) 761-4200 ext. 1

Other identifiers 6

IdentifierTypeStateIssuer
G8913071OtherWAPTAN
G8913072OtherWAPTAN
G8913070OtherWAPTAN
G8913073OtherWAPTAN
G8913074OtherWAPTAN
G8913075OtherWAPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121203000438 WA Practitioner - Diagnostic Radiology 5597917286 Reassigns benefits to 4 organizations
I20180510002472 OR Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 5597917286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tra-Minw P SGroup PAC ID 2163316167, 152 clinicians

Practice addresses (Care Compare)

222 15TH Ave SE
Puyallup, WA 98372-3754
Phone (253) 841-4353

2801 St Anthony Way
Pendleton, OR 97801-3800
Phone (253) 841-4353

34515 9TH Ave S
Federal Way, WA 98003-6761
Phone (253) 841-4353

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60149277WAMDDiagnostic Radiology Physician
4301088522MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Tra-Minw P S CurrentSince Sep 5, 2012 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Mar 1, 2017 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Sep 5, 2012 Accepting new patients
Tra-Minw P S CurrentSince Sep 5, 2012 Accepting new patients
Tra-Minw, PS Diagnostic Radiology CurrentSince Jun 1, 2018 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Aug 1, 2014 Accepting new patients
Tra Medical Imaging Centers LLC CurrentSince Dec 1, 2025 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance Past Accepting new patients

Locations (25 of 26)

2801 St Anthony Way
Pendleton, OR 97801
Phone (541) 276-5121

122 3rd St NE
Auburn, WA 98002
Phone (253) 833-7750

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

21110 Sr 410 E
Ste 110
Bonney Lake, WA 98391

5900 State Highway 303 NE
Bremerton, WA 98311
Phone (253) 459-6633

3021 Griffin Ave
Enumclaw, WA 98022
Phone (253) 833-6241

1455 Battersby Ave
Enumclaw, WA 98022
Phone (253) 552-5615

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

33915 1st Way S
Ste 130
Federal Way, WA 98003
Phone (253) 528-9135

4700 Point Fosdick Dr
Ste 110
Gig Harbor, WA 98335
Phone (253) 759-2622

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

500 Lilly Rd NE
Ste 160
Olympia, WA 98506
Phone (360) 413-8383

11212 Sunrise Blvd E
Ste 200
Puyallup, WA 98374

222 15th Ave SE
Puyallup, WA 98372

3400 California Ave SW
Seattle, WA 98116
Phone (206) 320-3399

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

1304 Fawcett Ave
Ste 200
Tacoma, WA 98402
Phone (253) 680-3555

1624 S I St
Ste 405
Tacoma, WA 98405
Phone (253) 274-4545

5919 100th St SW
Tacoma, WA 98499

1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372

1724 West Union Ave
Ste 100
Tacoma, WA 98405
Phone (253) 830-5200

2209 E 32nd St
Tacoma, WA 98404
Phone (206) 593-0244

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

4525 S 19th St
Tacoma, WA 98405
Phone (253) 759-2622

2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ei-trami

Organizations & group practices 8

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

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1639382302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 Fawcett Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984021911",
            "country_code": "US",
            "telephone_number": "253-761-4200 x1",
            "fax_number": "253-383-3553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREDEWEG",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60149277",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301088522",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD60149277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G8913071",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G8913072",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G8913070",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G8913073",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G8913074",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G8913075",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.