| Doctor Name: | COLIN RYAN |
| NPI Number: | 1003246935 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 321 Se 3rd St Toledo, OR - 973911613 |
| Business Phone Number: | 5413362254 |
| Business Fax Number: | |
| Mailing Address: | 321 Se 3rd St, TOLEDO |
| State: | OR |
| Postal Code: | 973911613 |
| Phone Number: | 5413362254 |
| Fax Number: | |
| NPI Enumeration Date: | 11/13/2013 |
| NPI Last Update Date: | 11/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |