MEDICARE: JAMES RYAN CASE ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0401X	Addiction Medicine (Family Medicine) Physician	RN60262699	WA
2	363LF0000X	Family Nurse Practitioner	AP60942015	WA

General Provider Information

NPI Number	:	1457816035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES RYAN CASE ARNP

Provider Business Mailing Address
First Line	:	111 UNIVERSITY PKWY STE 104
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98901-1448
Country	:	US
Telephone Number	:	509-767-6447
Fax Number	:	509-902-0537

Provider Business Practice Location Address
First Line	:	111 UNIVERSITY PKWY STE 104
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98901-1448
Country	:	US
Telephone Number	:	509-767-6447
Fax Number	:	509-225-9415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2019
Last Update Date	:	04/10/2025

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