Provider Demographics
NPI:1174367999
Name:BARBER, RYAN JUDSON (AC61523898)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:JUDSON
Last Name:BARBER
Suffix:
Gender:M
Credentials:AC61523898
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 ASTOR ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2915
Mailing Address - Country:US
Mailing Address - Phone:360-715-1824
Mailing Address - Fax:
Practice Address - Street 1:1303 ASTOR ST STE 101
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2915
Practice Address - Country:US
Practice Address - Phone:360-715-1824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61523898171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist