RYAN FAIRLEY (NPI# 1144606229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144606229 |
| Entity Type | Individual |
| Full Name | RYAN FAIRLEY |
| Practice Address |
1040 Nw 22nd Ave Ste 520 Portland OR 97210-3097 |
| Mailing Address |
Po Box 3808 Portland OR 97208-3808 |
| Practice Telephone | 5034137557 |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2020-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | DO197810 | OR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | PENDING | 05 |
| Street Address |
1040 NW 22ND AVE STE 520 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210-3097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922322510 | Sarah E Saltzberg | Dietitian, Registered | 1040 Nw 22nd Ave Ste 520, Portland, OR 97210-3097 | 2010-03-25 |
| 1699232868 | Daniela Matza | Dietitian, Registered | 1040 Nw 22nd Ave Ste 520, Portland, OR 97210-3097 | 2019-02-25 |
| 1609362672 | Megan A Beck | Dietitian, Registered | 1040 Nw 22nd Ave Ste 520, Portland, OR 97210-3097 | 2018-07-02 |
| 1669979043 | Emily Campbell | Dietitian, Registered | 1040 Nw 22nd Ave Ste 520, Portland, OR 97210-3097 | 2018-04-11 |
| 1942715339 | Asani H Seawell | Psychologist | 1040 Nw 22nd Ave Ste 520, Portland, OR 97210-3097 | 2017-12-06 |
| 1932641099 | Claire Tenenbaum | Physical Therapist | 1040 Nw 22nd Ave Ste 520, Portland, OR 97210 | 2016-11-07 |
| 1184052169 | Megan Antosik | Dietitian, Registered | 1040 Nw 22nd Ave Ste 520, Portland, OR 97210 | 2013-10-29 |
| 1598056277 | Laura R Schaffer | Dietitian, Registered | 1040 Nw 22nd Ave Ste 520, Portland, OR 97210 | 2011-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109086 | Joseph Francolino | Massage Therapist | 2174 Nw Davis Street, Apartment 105, Portland, OR 97210 | 2020-03-17 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1649769480 | Dipesh Patel | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 | 2018-05-08 |
| 1760987234 | Meghan Teague | Student in an Organized Health Care Education/Training Program | Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 | 2018-03-27 |
| 1205349172 | Paul M Storm | Acupuncturist | 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 | 2017-11-14 |
| 1740703750 | Audra K Berning | Massage Therapist | 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 | 2017-07-21 |
| 1720539810 | Anna-marie Elizabeth Wood | Audiologist | 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 | 2016-10-24 |
| 1659829836 | H&s Pearl, LLC | Massage Therapist | 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 | 2016-09-15 |
| 1255785796 | Cortez Natural Medicine, Inc. | Acupuncturist | 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 | 2016-04-21 |
| 1932563616 | Vincent Chen | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 | 2016-04-08 |
| Find all providers in zip 97210 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386168029 | Northwest Minimally Invasive Surgery, LLC | Surgery | 2222 Nw Lovejoy St Ste 322, Portland, OR 97210-5101 | 2017-08-02 |
| 1366897399 | Andreas Hennig | Surgery | 783 Nw Naito Pkwy Apt 502, Portland, OR 97209-4755 | 2016-04-27 |
| 1871989467 | Cameron Cangelose | Surgery | 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239-3098 | 2015-04-09 |
| 1396157962 | Fernando Leon | Surgery | 2221 Sw First Ave Apt 2322, Portland, OR 97201-5023 | 2014-05-29 |
| 1114337466 | Thomas B Knowles | Surgery | 1130 Nw 22nd Ave Ste 500, Portland, OR 97210-2976 | 2014-05-07 |
| 1659714160 | Sean Tyler Watters | Surgery | 5050 Ne Hoyt St Ste 651, Portland, OR 97213 | 2013-04-15 |
| 1528301926 | Vincent A. Reger, Md PC | Surgery | 9155 Sw Barnes Rd Ste 406, Portland, OR 97225-6641 | 2013-04-03 |
| 1235496944 | Lori Cardwell | Surgery | Ohsu Gastrointestinal & General Surgery At Chh, 3303 Sw Bond Avenue, Portland, OR 97239-4501 | 2012-04-19 |
| 1053678284 | Tyler Scott Mittelstaedt | Surgery | 9200 Se 91st Ave Ste 320, Portland, OR 97086-3756 | 2012-04-12 |
| 1285990721 | John David Webber | Surgery | 12155 Sw Wildwood St, Portland, OR 97224-2919 | 2012-04-10 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.