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General NPI Number Information
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NPI Number | 1073050241
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Entity Type | Organization
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Legal Business Name | RYDER JOHANSON, L.AC.
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Dates
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Enumeration Date | 01/26/2017
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 233 4TH ST
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City | ASHLAND
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State | OR
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Zip | 97520-2043
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Country | US
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Telephone | 541-500-7233
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Fax |
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Provider Business Mailing Address
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Address Line | 337 TAYLOR ST
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City | ASHLAND
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State | OR
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Zip | 97520-3057
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Country | US
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Telephone | 541-500-7233
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | RYDER KARDOKAS-JOHANSON
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Credential | L.AC.
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Telephone | 541-500-7233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC180365
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License Number State | OR
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