Individual
RYUSHIN HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, CSWA, CADC I
Contact information
Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835
(541) 766-6164
Mailing address
PO BOX 579, CORVALLIS, OR 97339-0579
(541) 766-6835
(541) 766-6164
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18-10-06
OR
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500744748
—
OR
Enumeration date
02/23/2015
Last updated
05/10/2020
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