Individual
CODY RYAN CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
360 E 10TH AVE STE 308, EUGENE, OR 97401-3687
(833) 646-3633
Mailing address
360 E 10TH AVE STE 308, EUGENE, OR 97401-3687
(833) 646-3633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA210353
OR
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA210353
OREGON MEDICAL LICENSE
OR
Enumeration date
03/09/2021
Last updated
03/12/2026
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