DR. RYAN BEETHAM (NPI# 1669025680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669025680 |
| Entity Type | Individual |
| Full Name | DR. RYAN BEETHAM |
| Credential | DMD |
| Practice Address |
Us Army Dentac 9900 Lincoln Street, 2nd Floor Tacoma WA 98327 |
| Mailing Address |
9900 Lincoln Street, 2nd Floor, Attn: Credential Office Us Army Dentac Tacoma WA 98327 |
| Practice Telephone | 2539684079 |
| Mailing Telephone | 2539684079 |
| Mailing Fax Number | 2539685919 |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
US ARMY DENTAC 9900 LINCOLN STREET, 2ND FLOOR |
| City | TACOMA |
| State | WA |
| Zip Code | 98327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326693243 | Zachary Daniel White | Dentist | Us Army Dentac, 9900 Lincoln St 2nd Floor, Tacoma, WA 98327 | 2019-08-07 |
| 1912568031 | Schuler Preston Luce | Student in an Organized Health Care Education/Training Program | Us Army Dentac, 9900 Lincoln Street, 2nd Floor, Tacoma, WA 98327 | 2019-06-28 |
| 1306404959 | Alan George | Dentist | Us Army Dentac, 9900 Lincoln Street, 2nd Floor, Tacoma, WA 98327 | 2019-05-30 |
| 1538725544 | Jonna Lee Obermiller | Dental Hygienist | Us Army Dentac, 9900 Lincoln Street 2nd Floor, Tacoma, WA 98327 | 2019-05-15 |
| 1689120891 | Cierra Diamse | Dentist | Us Army Dentac, 9900 Lincoln Street, 2nd Floor, Tacoma, WA 98327 | 2016-08-28 |
| 1629524848 | Heung Yoo | Dentist | Us Army Dentac, 9900 Lincoln Street, 2nd Floor, Tacoma, WA 98327 | 2016-08-28 |
| 1093123572 | Deepa Ramasamy | Dentist | Us Army Dentac, Bldg 9900, 2nd Floor Lincoln St., Tacoma, WA 98431-0001 | 2014-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124683610 | Kathryn Michele Hines | Behavior Technician | 1570 Wilmington Dr #220, Dupont, WA 98327 | 2019-05-09 |
| 1841785730 | Ethan Earl Tindall | Dentist | 9900 Lincoln St, 2nd Floor, Us Army Dentac, Tacoma, WA 98327 | 2018-06-25 |
| 1962996272 | William Thomas Frei | Dentist | 9900 Lincoln St, 2nd Floor, Attn: Credentials Office, Us Army Dentac, Tacoma, WA 98327 | 2018-06-20 |
| 1659873453 | Jacqueline Patrick | Dental Assistant | 9900 Lincoln Street, 2nd Florr, Us Army Dentac, Tacoma, WA 98327 | 2018-03-07 |
| 1215436431 | Careage Home Health LLC | Home Health | 1600 Marshall Circle, Dupont, WA 98327 | 2018-02-02 |
| 1649621400 | Charles Walter Woodruff II | Dentist | Joint Base Lewis-mccord Dentac, Dental Clinic 3, Jblm, WA 98327 | 2016-06-23 |
| 1164898532 | Richard Lauderback | Dentist | 9900 Lincoln Street, 2nd Floor, Attn: Credentials Office, Tacoma, WA 98327 | 2015-08-19 |
| 1639552110 | Philip Henzlik | Dentist | 9900 Lincoln St. 2nd Floor, Us Army Dentac, Tacoma, WA 98327 | 2015-07-02 |
| 1861731739 | Elizabeth Brooke Stout | Behavioral Analyst | 1570 Wilmington Drive, Ste 220, Dupont, WA 98327 | 2013-02-12 |
| 1184902116 | Lidiya Kozlova | Massage Therapist | 5006 Center St Dr Ste N, Aim Physical Therapy, Tacoma, WA 98327 | 2011-07-25 |
| Find all providers in zip 98327 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780292466 | Katharine Ishida | Student in an Organized Health Care Education/Training Program | 1933 Dock St Unit 428, Tacoma, WA 98402-3273 | 2020-07-17 |
| 1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
| 1326675984 | Kyle Wilburn | Student in an Organized Health Care Education/Training Program | 1202 Martin Luther King Jr Way Ste 310, Tacoma, WA 98405-3926 | 2020-03-24 |
| 1629601265 | Andrew Tran Do | Student in an Organized Health Care Education/Training Program | 3401 49th St Ne, Tacoma, WA 98422-4617 | 2020-02-21 |
| 1033742986 | Molly Elisabeth Chandler | Student in an Organized Health Care Education/Training Program | 9409 Jackson Ave, Tacoma, WA 98431-0001 | 2020-02-19 |
| 1801434469 | Zachary Smith | Student in an Organized Health Care Education/Training Program | 1001 N Yakima Ave Apt 107, Tacoma, WA 98403-2536 | 2019-12-13 |
| 1912544941 | Laura Weeks | Student in an Organized Health Care Education/Training Program | 1010 122nd St S, Tacoma, WA 98447-0001 | 2019-12-10 |
| 1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
| 1154967339 | Angela Kennedy | Student in an Organized Health Care Education/Training Program | 12180 Park Ave S Pacific Lutheran University, Tacoma, WA 98447-0001 | 2019-11-21 |
| 1174171771 | Natali Barnes | Student in an Organized Health Care Education/Training Program | Business Mailing Address 9040 Jackson Ave, Tacoma, WA 98431-5650 | 2019-08-28 |
| Find all providers in TACOMA | ||||
Please comment or provide details below to improve the information on DR. RYAN BEETHAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.