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General NPI Number Information
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NPI Number | 1447953161
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Entity Type | Organization
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Legal Business Name | SPRY CLINIC
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Dates
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Enumeration Date | 03/22/2023
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 309 2ND ST SE
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City | AUBURN
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State | WA
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Zip | 98002-5543
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Country | US
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Telephone | 206-400-7077
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Fax |
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Provider Business Mailing Address
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Address Line | 5431 N PEPPARD AVE
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City | MERIDIAN
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State | ID
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Zip | 83646-6684
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Country | US
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Telephone | 951-741-7023
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RYAN DANIEL BIAS
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Credential |
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Telephone | 714-223-5920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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