Organization
KEVIN RYAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN T RYAN LMFT (COUNSELOR / PRACTIONEER)
(541) 296-6114
Entity
Organization
Contact information
Practice address
119 E 2ND ST STE 210, THE DALLES, OR 97058-1796
(541) 296-6114
(541) 296-6577
Mailing address
119 E 2ND ST STE 210, THE DALLES, OR 97058-1796
(541) 340-0402
(541) 296-6577
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T1402
OREGON LICENSE
OR
Enumeration date
03/21/2020
Last updated
09/18/2024
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