| Doctor Name: | DR. RYAN MARENDIUK |
| NPI Number: | 1093965816 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | N.P. |
| License Number: | 48298 |
| Business Practice Address: | 3726 E Mullan Ave Post Falls, ID - 838549852 |
| Business Phone Number: | 2087772489 |
| Business Fax Number: | |
| Mailing Address: | 3726 E Mullan Ave, POST FALLS |
| State: | ID |
| Postal Code: | 838549852 |
| Phone Number: | 2087772489 |
| Fax Number: | |
| NPI Enumeration Date: | 09/29/2008 |
| NPI Last Update Date: | 10/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA2000X |
| License Number: | 48298 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | HI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Administrator |
| Taxonomy Definition: | |