MR. JERRY DAVID RYAN LPC.CRC.NCCMS NPI 1245667385

NPI Information

NPI: 1245667385
Provider Name: MR. JERRY DAVID RYAN, LPC.CRC.NCC,MS
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
19142 MOLALLA AVE., SUITE A,
OREGON CITY, OR
ZIP 97045
Phone: (503) 348-6177
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MR. Jerry David Ryan, LPC.CRC.NCC,MS is a professional counselor in Oregon City, OR. MR. Jerry David Ryan, LPC.CRC.NCC,MS NPI is 1245667385. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

19142 MOLALLA AVE., SUITE A,
OREGON CITY, OR
ZIP 97045-166
Phone: (503) 348-6177
Fax: (593) 632-5497

The enumeration date for this NPI number is 10/3/2013 and was last updated on 11/10/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	R2757	OREGON	No
2	101YP2500X	Counselor	Professional		OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5006884107	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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