Provider Demographics
NPI:1134475437
Name:MCDANIEL, PATRICK RYAN (M ED)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:RYAN
Last Name:MCDANIEL
Suffix:
Gender:M
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 SAGE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-2035
Mailing Address - Country:US
Mailing Address - Phone:925-216-8661
Mailing Address - Fax:
Practice Address - Street 1:576 OLIVE ST STE 204
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2650
Practice Address - Country:US
Practice Address - Phone:541-841-9853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT1316106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist