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General NPI Number Information
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NPI Number | 1407172513
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Entity Type | Individual
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Provider Name | RYAN MICHAEL YATES D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 09/21/2021
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Provider Practice Location Address
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Address Line | 2310 N MOLTER RD SUITE 108
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-5036
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Country | US
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Telephone | 509-924-4443
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Fax |
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Provider Business Mailing Address
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Address Line | 4752 136TH AVE
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City | HAMILTON
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State | MI
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Zip | 49419-9015
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Country | US
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Telephone | 269-264-1260
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Fax | 269-264-1226
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 60137571
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License Number State | WA
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