Healthcare Provider Details

I. General information

NPI: 1386566164
Provider Name (Legal Business Name): RYAN D FOWLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SW BARTON ST STE D3
SEATTLE WA
98126-4052
US

IV. Provider business mailing address

25207 234TH AVE SE
MAPLE VALLEY WA
98038-6096
US

V. Phone/Fax

Practice location:
  • Phone: 206-573-5074
  • Fax:
Mailing address:
  • Phone: 425-282-8152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: