Provider Demographics
NPI:1871391375
Name:RYAN, PAULA JOLENE JONES (EDS)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JOLENE JONES
Last Name:RYAN
Suffix:
Gender:
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80596 UMATILLA RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-6658
Mailing Address - Country:US
Mailing Address - Phone:406-396-3367
Mailing Address - Fax:
Practice Address - Street 1:80596 UMATILLA RIVER RD
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-6658
Practice Address - Country:US
Practice Address - Phone:406-396-3367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR515271103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool