Provider Demographics
NPI:1174042527
Name:STOKES, RYLIE
Entity Type:Individual
Prefix:
First Name:RYLIE
Middle Name:
Last Name:STOKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 E 11TH AVE # LL2
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3601
Mailing Address - Country:US
Mailing Address - Phone:541-359-1009
Mailing Address - Fax:541-359-1039
Practice Address - Street 1:488 E 11TH AVE # LL2
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3601
Practice Address - Country:US
Practice Address - Phone:541-359-1009
Practice Address - Fax:541-359-1039
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR444242225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist