Active NPI
Alica Breann Ryan, NTP. MS
- Nutritionist
- Gig Harbor, WA
National Provider Identifier
1699327650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- NU60978366
- Practice address
- 11515 Burnham Dr NW
Gig Harbor, WA 98332-8543 - Phone
- (253) 858-5152
- NPI assigned
- Jul 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | NU60978366 | WA | Primary |
Addresses
Primary practice location
11515 Burnham Dr NW
Gig Harbor, WA 98332-8543
Mailing address
11515 Burnham Dr NW
Gig Harbor, WA 98332-8543
Phone (253) 858-5152
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NU60978366 | WA | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562716800000",
"number": "1699327650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11515 BURNHAM DR NW",
"city": "GIG HARBOR",
"state": "WA",
"postal_code": "983328543",
"telephone_number": "253-858-5152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11515 BURNHAM DR NW",
"city": "GIG HARBOR",
"state": "WA",
"postal_code": "983328543",
"telephone_number": "253-858-5152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "ALICA",
"middle_name": "BREANN",
"name_prefix": "Mrs.",
"credential": "NTP. MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-10",
"last_updated": "2019-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "WA",
"license": "NU60978366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gig Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.