Basic Information
Provider Information
NPI: 1508826843
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOWNSEND
FirstName: RYAN
MiddleName: PATRICK
NamePrefix: MR.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 421
Address2:  
City: LIBERTY LAKE
State: WA
PostalCode: 990190421
CountryCode: US
TelephoneNumber: 5097472455
FaxNumber:  
Practice Location
Address1: 105 W 5TH AVE STE 418C
Address2:  
City: SPOKANE
State: WA
PostalCode: 992044820
CountryCode: US
TelephoneNumber: 5094746920
FaxNumber: 5092277070
Other Information
ProviderEnumerationDate: 03/23/2006
LastUpdateDate: 04/16/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XAP30006995WAN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LP0808XAP30006995WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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