Healthcare Provider Details

I. General information

NPI: 1417228024
Provider Name (Legal Business Name): JASON RYAN LAW ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2671 NE 46TH ST
SEATTLE WA
98105-5041
US

IV. Provider business mailing address

PO BOX 741515
LOS ANGELES CA
90074-1515
US

V. Phone/Fax

Practice location:
  • Phone: 206-525-8000
  • Fax:
Mailing address:
  • Phone: 206-535-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60254262
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: