MEDICARE: RYAN JAMES HILL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist		OR

General Provider Information

NPI Number	:	1538810601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN JAMES HILL

Provider Business Mailing Address
First Line	:	3647 HIGHWAY 39
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603
Country	:	US
Telephone Number	:	458-254-4465
Fax Number	:

Provider Business Practice Location Address
First Line	:	3647 HWY 39
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-9760
Country	:	US
Telephone Number	:	458-254-4465
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2022
Last Update Date	:	01/11/2022

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Directions to “ RYAN JAMES HILL ” Practice Location

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