| Doctor Name: | RYAN WILLIS |
| NPI Number: | 1871932491 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | PT60366827 |
| Business Practice Address: | 2726 Griffin Ave Suite C Enumclaw, WA - 980222362 |
| Business Phone Number: | 3608026757 |
| Business Fax Number: | |
| Mailing Address: | 5904 159th Ave E, Apt C SUMNER |
| State: | WA |
| Postal Code: | 983903322 |
| Phone Number: | 9716781755 |
| Fax Number: | |
| NPI Enumeration Date: | 06/17/2013 |
| NPI Last Update Date: | 06/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT60366827 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |