MEDICARE: COLLEEN RYAN

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	225X00000X	Occupational Therapist	6099-26	WI

General Provider Information

NPI Number	:	1700734803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN RYAN

Provider Business Mailing Address
First Line	:	2222 E WASHINGTON AVE
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53704-5210
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 E WASHINGTON AVE
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53704-5210
Country	:	US
Telephone Number	:	608-204-1783
Fax Number	:

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

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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Directions to “ COLLEEN RYAN ” Practice Location

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