Healthcare Provider Details

I. General information

NPI: 1073140083
Provider Name (Legal Business Name): RYAN JEFFREY STONE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16233 SYLVESTER RD SW STE G10
BURIEN WA
98166-3069
US

IV. Provider business mailing address

16233 SYLVESTER RD SW STE G10
BURIEN WA
98166-3069
US

V. Phone/Fax

Practice location:
  • Phone: 206-242-6553
  • Fax: 206-246-0468
Mailing address:
  • Phone: 206-242-6553
  • Fax: 206-246-0468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO61393847
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: