Individual
RYAN L ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, CADC I
Contact information
Practice address
24461 E WELCHES RD, WELCHES, OR 97067-7067
(971) 333-0494
(971) 715-4185
Mailing address
PO BOX 729, WELCHES, OR 97067-0729
(971) 333-0494
(971) 715-4185
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19-07-07
OR
101YM0800X
Mental Health Counselor
A4926
OR
1041C0700X
Clinical Social Worker
Primary
L8595
OR
Other
Enumeration date
06/19/2017
Last updated
01/21/2026
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