| Kevin Ryan Pc | |
|
119 E 2nd St Ste 210 The Dalles OR 97058-1796 | |
| (541) 296-6114 | |
| (541) 296-6577 |
| Full Name | Kevin Ryan Pc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 119 E 2nd St Ste 210, The Dalles, Oregon |
| Authorized Official Name and Position | Kevin T Ryan (COUNSELOR / PRACTIONEER) |
| Authorized Official Contact | 5412966114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Ryan Pc 119 E 2nd St Ste 210 The Dalles OR 97058-1796 Ph: (541) 340-0402 | Kevin Ryan Pc 119 E 2nd St Ste 210 The Dalles OR 97058-1796 Ph: (541) 296-6114 |
| NPI Number | 1972139947 |
|---|---|
| Provider Enumeration Date | 03/21/2020 |
| Last Update Date | 09/18/2024 |
| Certification Date | 09/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972139947 | NPI | - | NPPES |
| T1402 | Other | OR | OREGON LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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