Provider Demographics
NPI:1336979806
Name:BARKER, DANIEL RYAN (MSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:RYAN
Last Name:BARKER
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 1:165 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-4223
Mailing Address - Country:US
Mailing Address - Phone:541-405-4622
Mailing Address - Fax:541-405-4381
Practice Address - Street 1:165 S MAIN ST
Practice Address - Street 2:OPTIONAL
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-4223
Practice Address - Country:US
Practice Address - Phone:541-405-4622
Practice Address - Fax:541-405-4381
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA15298104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker