NPIMap

Individual provider Active NPI

Ryan Gunter

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1518334028
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA174629 Issued in OR
Practice address
135 NE 102ND Ave
Portland, OR 97220-4167
Phone
(503) 894-9005
Fax
(503) 719-4178
NPI assigned
Sep 1, 2015
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA174629 OR Primary
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

135 NE 102ND Ave
Portland, OR 97220-4167

Mailing address

135 NE 102ND Ave
Portland, OR 97220-4167
Phone (503) 894-9005

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lzavala34256@yvfwc.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151119003039 OR Practitioner - Physician Assistant 8325358658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1321 NE 99TH Ave
Suite 100
Portland, OR 97220-9437
Phone (503) 215-9900

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2024 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Dec 1, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2024 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

589 NW 11th St
Hermiston, OR 97838
Phone (503) 567-1717

1336 NE Orenco Station Pkwy
Hillsboro, OR 97124

1840 E Portland Rd
Newberg, OR 97132
Phone (503) 538-9360

1321 NE 99th Ave
Ste 100
Portland, OR 97220
Phone (503) 215-4050

135 NE 102nd Ave
Portland, OR 97220
Phone (503) 255-5388

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

8935 SE Powell Blvd
Portland, OR 97266
Phone (503) 349-7864

800 5th Ave
Ste 9
Seattle, WA 98104

Interoperability endpoints

  • Direct secure messaging: rgunter1705294@oc.providencedirect.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1518334028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 NE 102ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204167",
            "telephone_number": "503-894-9005",
            "fax_number": "503-719-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 NE 102ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204167",
            "telephone_number": "503-894-9005",
            "fax_number": "503-719-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNTER",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-01",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA174629",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lzavala34256@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "135 NE 102nd Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972204167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.