Provider Demographics
NPI:1255461224
Name:WOOD, RYAN R (ND, DC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:R
Last Name:WOOD
Suffix:
Gender:M
Credentials:ND, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11790 SW BARNES RD STE 120
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5938
Mailing Address - Country:US
Mailing Address - Phone:503-799-6115
Mailing Address - Fax:
Practice Address - Street 1:11790 SW BARNES RD STE 120
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5938
Practice Address - Country:US
Practice Address - Phone:503-799-6115
Practice Address - Fax:833-606-1224
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5651111NX0800X
OR3093175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No111NX0800XChiropractic ProvidersChiropractorOrthopedic