Laura A Ryan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10004074 Issued in WA

Practice address

32014 Little Boston Rd NE
Kingston, WA 98346-9734

Phone

(360) 297-9601

Fax

(360) 297-9614

NPI assigned

Aug 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: laura.ryan.p1@direct.pgsklallamtribe.nextgenshare.com

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.

• Port Gamble S'Klallam Tribe

  • Federally Qualified Health Center (FQHC)
  • Kingston, WA
  • NPI 1760428650
  Medicare reassignment
• Port Gamble S'Klallam Tribe

  • Federally Qualified Health Center (FQHC)
  • Kingston, WA
  • NPI 1518585579
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972610202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32014 LITTLE BOSTON RD NE",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983469734",
            "telephone_number": "360-297-9601",
            "fax_number": "360-297-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32014 LITTLE BOSTON RD NE",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983469734",
            "telephone_number": "360-297-9601",
            "fax_number": "360-297-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "LAURA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I ID#",
            "identifier": "01677227",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RIDER#",
            "identifier": "5163RY",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KPS ID#",
            "identifier": "910875163-38",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8350498",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Port Gamble S'Klallam Tribe
• Dian Aletha Poyssick, RPH
• Megan Elizabeth Pratt, L.M.P.
• Puget Sound Senior Care, LLC
• Ruby Elizabeth Roberts, LICSW
• Dorie M Salem-Soule, DENTAL HYGIENIST
• Piero Francis Sandri, MD
• Ted M Schmid
• Stacy Schmidt
• Sean M Couch DDS PS

• Medical Physician Assistant in Kingston, WA
• Providers in Kingston, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.