Healthcare Provider Details

I. General information

NPI: 1639000904
Provider Name (Legal Business Name): RYAN ANTHONY DISCH MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RYAN DISCH-GUZMAN

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26526 99TH AVE SW
VASHON WA
98070-8407
US

IV. Provider business mailing address

26526 99TH AVE SW
VASHON WA
98070-8407
US

V. Phone/Fax

Practice location:
  • Phone: 505-670-8662
  • Fax:
Mailing address:
  • Phone: 505-670-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWIA.SC.60811589
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: