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General NPI Number Information
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NPI Number | 1134475437
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Entity Type | Individual
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Provider Name | PATRICK RYAN MCDANIEL M. ED.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2012
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 576 OLIVE ST STE 204
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City | EUGENE
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State | OR
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Zip | 97401-2650
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Country | US
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Telephone | 541-841-9853
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Fax |
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Provider Business Mailing Address
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Address Line | 2612 SAGE ST
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City | EUGENE
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State | OR
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Zip | 97404-2035
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Country | US
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Telephone | 925-216-8661
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T1316
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License Number State | OR
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