Provider Demographics
NPI:1225911084
Name:TAVES, RYAN LEE (DAC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:LEE
Last Name:TAVES
Suffix:
Gender:M
Credentials:DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 S DEFRAME ST UNIT C2
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-6000
Mailing Address - Country:US
Mailing Address - Phone:303-501-9024
Mailing Address - Fax:
Practice Address - Street 1:1629 S DEFRAME ST UNIT C2
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-6000
Practice Address - Country:US
Practice Address - Phone:303-501-9024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2935171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist