Provider Demographics
NPI:1407339047
Name:RYAN-PUGH, JOSIE LEANNE (MSW)
Entity Type:Individual
Prefix:MS
First Name:JOSIE
Middle Name:LEANNE
Last Name:RYAN-PUGH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MR
Other - First Name:JOSHUA
Other - Middle Name:LEANDER
Other - Last Name:PUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3158 PRINGLE RD SE APT 15
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1686
Mailing Address - Country:US
Mailing Address - Phone:919-621-5796
Mailing Address - Fax:
Practice Address - Street 1:2411 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5824
Practice Address - Country:US
Practice Address - Phone:541-682-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program