Provider Demographics
NPI:1548790462
Name:NYMAN, GARRETT ALAN (MSW)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:ALAN
Last Name:NYMAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 SE 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-2307
Mailing Address - Country:US
Mailing Address - Phone:541-788-0145
Mailing Address - Fax:
Practice Address - Street 1:1333 NW 9TH ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1482
Practice Address - Country:US
Practice Address - Phone:541-447-2631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health