Most Relevant Information
Provider Data
| NPI Number: | 1003449935 |
| Provider Name: | RYAN MATTHEW TRAPP |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/19/2020 |
| Last Updated: | 03/30/2020 |
Provider Practice Location
1245 BIRCH AVE
COTTAGE GROVE
OR
974241413
Practice Location Phone/Fax
| Phone: | 5419423939 |
| Fax: | 5419423939 |
Provider Mailing Location
1245 BIRCH AVE
COTTAGE GROVE
OR
974241413
Provider Mailing Phone/Fax
| Phone: | 5416236068 |
| Fax: |