Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mary Kathryn Ryan, PA-C, ATL

Individual provider Athletic Trainer · NPI 1083038582

Mary Kathryn Ryan, PA-C, ATL is a Physician Assistant in Renton, Washington. Qualified in 2021, 5 years ago. Practices with Proliance Surgeons Inc P S, a 394-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Michigan and Washington.

Years since qualifying
5
Licensed in
MI, WA
In the registry since
2014
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4011 Talbot Rd S Ste 300
Renton, WA 98055-5791
Phone: (425) 656-5060
Fax: (425) 656-5047
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 1620 Lake Tapps Pkwy Se Ste 115, Auburn, WA 98092-8376 — (253) 246-2860
  • 27005 168th Pl Se Ste 201, Covington, WA 98042-4902 — (253) 630-3660
  • 24060 Se Kent Kangley Rd Ste D-100, Maple Valley, WA 98038-6851 — (425) 358-7708
  • 150 Andover Park W, Tukwila, WA 98188-2801 — (425) 979-2663

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA61227531 (WA)
Athletic Trainer Taxonomy 2255A2300X · Licence 2601001845 (MI)

Record details

NPI number1083038582
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , ATL
Sole proprietorNo
NPI enumeratedFebruary 5, 2014
Last updated in NPPESOctober 26, 2021
Certification dateOctober 26, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Proliance Surgeons Inc P S — 394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Renton