Individual provider Active NPI

Ryan Van Dam, PA

  • Physician Assistant
  • Westford, MA
National Provider Identifier
1639616949
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.PA.60730273 Issued in WA
Practice address
3 Thistle LN
Westford, MA 01886-4034
Phone
(978) 302-8217
NPI assigned
Jan 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.PA.60730273 WA Primary
Physician Assistant 363A00000X 2271480 ID

Addresses

Primary practice location

3 Thistle LN
Westford, MA 01886-4034

Mailing address

PO Box 31001-4141
Pasadena, CA 91110-0001
Phone (888) 227-3312

Other practice location 1

718 91st Ave NE
Lake Stevens, WA 98258-2420
Phone (888) 227-3312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170615001138 WA Practitioner - Physician Assistant 5698043677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

15870 1St Ave S
Suite 101
Burien, WA 98148-1301
Phone (206) 242-2501

222 State Ave N
Kent, WA 98030-4544
Phone (253) 372-7788

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince May 29, 2018 Accepting new patients
Multicare Health System CurrentSince May 29, 2018 Accepting new patients
Express Care Or PC Past Accepting new patients

Locations

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

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: rvandam355139@direct.multicare.org

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.

Hospital & facility affiliations 1

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": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1639616949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-4141",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100001",
            "telephone_number": "888-227-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 THISTLE LN",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018864034",
            "telephone_number": "978-302-8217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 91st Ave NE",
            "address_purpose": "LOCATION",
            "city": "Lake Stevens",
            "state": "WA",
            "postal_code": "982582420",
            "country_code": "US",
            "telephone_number": "888-227-3312",
            "fax_number": "425-259-8630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DAM",
        "first_name": "RYAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-24",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA.PA.60730273",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "2271480",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westford, MA

Sources for this page

Verify at the official NPI Registry.