Provider Demographics
NPI:1811548704
Name:HEER, RYAN (ND)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:HEER
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MUNICIPAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-1634
Mailing Address - Country:US
Mailing Address - Phone:317-426-7557
Mailing Address - Fax:
Practice Address - Street 1:1567 SE TACOMA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-6643
Practice Address - Country:US
Practice Address - Phone:503-233-8113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4273207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine