Provider Demographics
NPI:1144649674
Name:QUIRK, RYAN JOHN (PHD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JOHN
Last Name:QUIRK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 21ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3528
Mailing Address - Country:US
Mailing Address - Phone:253-693-8559
Mailing Address - Fax:
Practice Address - Street 1:8300 21ST AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3528
Practice Address - Country:US
Practice Address - Phone:253-693-8559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-11
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60178861103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical