Individual
RYEANN NICOLE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
155 NE REVERE AVE, BEND, OR 97701-4147
(458) 206-5982
Mailing address
155 NE REVERE AVE STE 150, BEND, OR 97701-4147
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-25-4874
OR
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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