Provider Demographics
NPI:1639237688
Name:CASH, MILES RYAN (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:MILES
Middle Name:RYAN
Last Name:CASH
Suffix:
Gender:M
Credentials:ND, LAC
Other - Prefix:DR
Other - First Name:MINDY
Other - Middle Name:M
Other - Last Name:CASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND, LAC
Mailing Address - Street 1:4625 SE CENTER ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-3251
Mailing Address - Country:US
Mailing Address - Phone:503-772-1700
Mailing Address - Fax:
Practice Address - Street 1:4625 SE CENTER ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-3251
Practice Address - Country:US
Practice Address - Phone:503-772-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00647171100000X
OR1125175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR87-0734081OtherEIN