Individual
MS. CELESTE RYANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
843 E MAIN ST STE 208, MEDFORD, OR 97504-7137
(541) 500-8655
(800) 433-1396
Mailing address
219 VANCOUVER AVE, MEDFORD, OR 97504
(317) 407-5573
(833) 414-3961
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
34005730A
IN
1041C0700X
Clinical Social Worker
Primary
L4990
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100071720
—
IN
Enumeration date
07/09/2009
Last updated
06/08/2021
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