Provider Demographics
NPI:1265065643
Name:RYAN, BRITTANY (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 N CENTRAL AVE STE 407
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-5939
Mailing Address - Country:US
Mailing Address - Phone:541-690-9021
Mailing Address - Fax:
Practice Address - Street 1:33 N CENTRAL AVE STE 407
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-5939
Practice Address - Country:US
Practice Address - Phone:541-690-9021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR023105225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist