| Doctor Name: | SHANNON C RYAN |
| NPI Number: | 1154602746 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP |
| License Number: | 099000570RN |
| Business Practice Address: | 63 S 4th St Central Point, OR - 975022268 |
| Business Phone Number: | 5417277787 |
| Business Fax Number: | 5417277529 |
| Mailing Address: | 63 S 4th St, CENTRAL POINT |
| State: | OR |
| Postal Code: | 975022268 |
| Phone Number: | 5417277787 |
| Fax Number: | 5417277529 |
| NPI Enumeration Date: | 09/08/2011 |
| NPI Last Update Date: | 03/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 099000570RN |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |