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NPI Code Detail

MEDICARE: RYAN CROWLEY

MEDICARE: RYAN CROWLEY
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
11223G0001XGeneral Practice DentistryD8967OR

General Provider Information

NPI Number : 1215124052
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN CROWLEY
Provider Business Mailing Address
First Line : 1740 W 17TH AVE
Second Line :
City : EUGENE
State : OR
Zip : 97402-3619
Country : US
Telephone Number : 541-242-8909
Fax Number :
Provider Business Practice Location Address
First Line : 1880 LANCASTER DR NE STE 121
Second Line :
City : SALEM
State : OR
Zip : 97305-1069
Country : US
Telephone Number : 503-589-4515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2007
Last Update Date : 09/25/2007

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Directions to “ RYAN CROWLEY ” Practice Location

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