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General NPI Number Information
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NPI Number | 1740807577
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Entity Type | Individual
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Provider Name | RYAN TAM DDS
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Gender | Male
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Dates
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Enumeration Date | 06/27/2020
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Last Update Date | 06/27/2020
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Provider Practice Location Address
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Address Line | 2825 80TH AVE SE STE 3
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City | MERCER ISLAND
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State | WA
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Zip | 98040-2977
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Country | US
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Telephone | 206-232-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 9741 S 222ND ST
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City | KENT
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State | WA
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Zip | 98031-2410
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Country | US
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Telephone | 206-913-7392
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 0000000000
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License Number State | WA
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