Kevin Ryan PC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

KEVIN RYAN PC

Practice address

119 E 2ND St Ste 210
The Dalles, OR 97058-1796

Phone

(541) 296-6114

Fax

(541) 296-6577

NPI assigned

Mar 21, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kevin T Ryan, LMFTNPI 1033398284

Title

Counselor / Practioneer

Phone

(541) 296-6114

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Thomas Ryan, M.A., MFCT, LMFT

  • Marriage & Family Therapist
  • The Dalles, OR
  • NPI 1033398284
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1972139947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 E 2ND ST STE 210",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970581796",
            "telephone_number": "541-340-0402",
            "fax_number": "541-296-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E 2ND ST STE 210",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970581796",
            "telephone_number": "541-296-6114",
            "fax_number": "541-296-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN RYAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-21",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "COUNSELOR / PRACTIONEER",
        "authorized_official_telephone_number": "541-296-6114",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON LICENSE",
            "identifier": "T1402",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "KTRcounselor@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "119 E 2nd St Ste 210",
            "city": "The Dalles",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970581796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Delese Kendrick, CADC, CGAC
• Kenneth V Miller D.C P.C
• Tiffany Kenslow, MSW
• Reid Ketcher, DMD
• Anna L Ketchum
• Amanda Khamsouthavong, PHARMD
• Edward E Kice III, M.D.
• Kyle Kim, PHARMD
• Jalen Michael King
• Lucille I Kirchner, MD

• Adult Mental Health Clinic/Center in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Adult Mental Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.