Provider Demographics
NPI:1386011401
Name:O'CLAIR, RYAN SCOTT (AUD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:SCOTT
Last Name:O'CLAIR
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 SW 13TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3206
Mailing Address - Country:US
Mailing Address - Phone:541-678-5698
Mailing Address - Fax:541-306-4551
Practice Address - Street 1:516 SW 13TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3206
Practice Address - Country:US
Practice Address - Phone:541-678-5698
Practice Address - Fax:541-306-4551
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR30835231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist