Active NPI
Tara Jean Ryan, PHD
- Forensic Psychologist
- Salem, OR
National Provider Identifier
1831939404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 3603
- Practice address
- 2600 Center St NE
Salem, OR 97301-2669 - Phone
- (503) 979-1881
- NPI assigned
- May 30, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | PSY.0005795 | CO | |
| Forensic Psychologist | 103TF0200X | 3603 | OR | Primary |
Addresses
Primary practice location
2600 Center St NE
Salem, OR 97301-2669
Mailing address
2600 Center St NE
Salem, OR 97301-2669
Phone (503) 979-1881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3603 | OR | MD | Psychologist |
| PSY.0005795 | CO | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1831939404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 CENTER ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973012669",
"telephone_number": "503-979-1881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 CENTER ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973012669",
"telephone_number": "503-979-1881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "TARA",
"middle_name": "JEAN",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-30",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CO",
"license": "PSY.0005795",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "OR",
"license": "3603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.