KEVIN RYAN PC (NPI# 1972139947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972139947 |
| Entity Type | Organization |
| Organization Name | KEVIN RYAN PC |
| Practice Address |
119 E 2nd St Ste 210 The Dalles OR 97058-1796 |
| Practice Telephone | 5412966114 |
| Practice Fax Number | 5412966577 |
| Mailing Telephone | 5412966114 |
| Mailing Fax Number | 5412966577 |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2020-03-21 |
| Authorized Official Name | KEVIN T RYAN (COUNSELOR / PRACTIONEER) |
| Authorized Official Telephone | 5413400402 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OREGON LICENSE | T1402 | 01 |
| Street Address |
119 E 2ND ST STE 210 |
| City | THE DALLES |
| State | OR |
| Zip Code | 97058-1796 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538646864 | Ashlee Kai Mcnamara | Behavior Technician | 2525 W 8th St., #34, The Dalles, OR 97058 | 2018-07-19 |
| 1548784689 | Mireya Moreno Ibarra | Behavior Technician | 401 East 3rd Street, Suite 101, The Dalles, OR 97058 | 2017-07-31 |
| 1407304991 | Joshua Seidel | Pharmacist | 515 Mt Hood St, The Dalles, OR 97058 | 2016-09-14 |
| 1366809048 | Mid-columbia Medical Center | Surgery | 1810 E. 19th St. #225, The Dalles, OR 97058 | 2016-01-26 |
| 1558731141 | Louise Goodnight | Case Manager/Care Coordinator | 419 East 7 Th Street, The Dalles, OR 97058 | 2015-09-25 |
| 1578944666 | Jessica Donnell | Dental Hygienist | 2529 E 12th St, The Dalles, OR 97058 | 2015-06-15 |
| 1487034328 | Savanna Schaan | Specialist | 609 W 14th St, The Dalles, OR 97058 | 2015-06-05 |
| 1801299102 | Mary E Zenorini | Social Worker | 1620 E. 12th St, The Dalles, OR 97058 | 2014-09-30 |
| 1669889143 | Diane Joan Irwin | Social Worker | 419 E 7th St #207, The Dalles, OR 97058 | 2014-07-17 |
| 1124452008 | Lacey A Nichols | Counselor | 312 E. Third St., The Dalles, OR 97058 | 2013-08-27 |
| Find all providers in zip 97058 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265039564 | Embodied Life Therapy Center LLC | Clinic/Center | 6906 N Richards St, Portland, OR 97203-6138 | 2020-10-08 |
| 1720685696 | Pragmatic Healing LLC | Clinic/Center | 3930 Sw Plum St Apt 1, Portland, OR 97219-6046 | 2020-10-05 |
| 1639793367 | Northwest Geriactrics | Clinic/Center | 10365 Se Sunnyside Rd Ste 340, Clackamas, OR 97015-5751 | 2020-05-28 |
| 1366065872 | Caring Hands Residential Services LLC | Clinic/Center | 16220 Se Mckinley Ave, Clackamas, OR 97015-9418 | 2020-05-19 |
| 1083240386 | Peace of Mind Functional Medicine | Clinic/Center | 151 Sw Shevlin Hixon Dr Ste 201, Bend, OR 97702-3233 | 2020-03-18 |
| 1467086215 | Deborah Ann Jewell | Clinic/Center | 5627 Ne Simpson St, Portland, OR 97218-2329 | 2020-03-01 |
| 1154802403 | Dr. Asha Stephen, LLC | Clinic/Center | 1234 Pearl St Ste 7, Eugene, OR 97401-3642 | 2018-08-24 |
| 1891272324 | Cressall Psychiatric LLC | Clinic/Center | 240 E 12th Ave, Eugene, OR 97401-3245 | 2018-07-26 |
| 1174023808 | Blake Locher Counseling, LLC | Clinic/Center | 1020 Sw Taylor St Ste 449, Portland, OR 97205-2556 | 2018-02-19 |
| 1134633100 | Paul Myers, Ph.d., LLC | Clinic/Center | 5441 Sw Macadam Ave Ste 104, Portland, OR 97239-3821 | 2017-11-28 |
| Find all providers with the same taxonomy | ||||
| City | THE DALLES |
| Zip Code | 97058 |
Please comment or provide details below to improve the information on KEVIN RYAN PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.