| Doctor Name: | LORI DAVIS RYAN |
| NPI Number: | 1023473352 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | AP60617377 |
| Business Practice Address: | 1044 11th Ave Longview, WA - 986322506 |
| Business Phone Number: | 3605758275 |
| Business Fax Number: | 3605751950 |
| Mailing Address: | Po Box 908, TOLEDO |
| State: | WA |
| Postal Code: | 985910908 |
| Phone Number: | 4066709452 |
| Fax Number: | |
| NPI Enumeration Date: | 12/31/2015 |
| NPI Last Update Date: | 02/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP60617377 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |