Provider Demographics
NPI:1306215165
Name:WESTRUM, RYAN P (MA)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:P
Last Name:WESTRUM
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9820 COVE DR
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55305-5800
Mailing Address - Country:US
Mailing Address - Phone:952-261-5269
Mailing Address - Fax:
Practice Address - Street 1:2920 BRYANT AVE S
Practice Address - Street 2:SUITE 106
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2195
Practice Address - Country:US
Practice Address - Phone:952-261-5269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist