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General NPI Number Information
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NPI Number | 1225083553
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Entity Type | Individual
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Provider Name | RYAN M TENNANT DDS
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Gender | Male
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 W MERCER ST STE. 205
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City | SEATTLE
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State | WA
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Zip | 98119-3995
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Country | US
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Telephone | 206-281-8300
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Fax | 206-281-0075
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Provider Business Mailing Address
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Address Line | 3257 26TH AVE W
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City | SEATTLE
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State | WA
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Zip | 98199-2823
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Country | US
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Telephone | 206-240-6415
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Fax | 206-352-3962
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE10286
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License Number State | WA
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