Provider Demographics
NPI:1447953161
Name:SPRY CLINIC
Entity type:Organization
Organization Name:SPRY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:BIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-223-5920
Mailing Address - Street 1:5431 N PEPPARD AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-6684
Mailing Address - Country:US
Mailing Address - Phone:951-741-7023
Mailing Address - Fax:
Practice Address - Street 1:309 2ND ST SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-5543
Practice Address - Country:US
Practice Address - Phone:206-400-7077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center