| Doctor Name: | RYAN CAVENDISH |
| NPI Number: | 1023352804 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW, CADC II |
| License Number: | |
| Business Practice Address: | 2210 N Eldorado Ave Klamath Falls, OR - 976016418 |
| Business Phone Number: | 5418831030 |
| Business Fax Number: | 5418842338 |
| Mailing Address: | 2210 N Eldorado Ave, KLAMATH FALLS |
| State: | OR |
| Postal Code: | 976016418 |
| Phone Number: | 5418831030 |
| Fax Number: | 5418842338 |
| NPI Enumeration Date: | 11/19/2012 |
| NPI Last Update Date: | 01/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |