Healthcare Provider Details

I. General information

NPI: 1659032423
Provider Name (Legal Business Name): RYAN LAMBERT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12039 NE 128TH ST STE 400
KIRKLAND WA
98034-3029
US

IV. Provider business mailing address

12039 NE 128TH ST STE 400
KIRKLAND WA
98034-3029
US

V. Phone/Fax

Practice location:
  • Phone: 425-899-4810
  • Fax:
Mailing address:
  • Phone: 425-899-4810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA70030349
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: