Ryeann Nicole Martin

Key facts

NPI

1740175876

Entity type

Individual (NPI type 1)

Primary specialty

Addiction (Substance Use Disorder) Counselor 101YA0400X

License

T-25-4874 (OR)

Practice address

155 NE Revere Ave
Bend, OR 97701-4147

Phone

(458) 206-5982

NPI assigned

Jun 10, 2025

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 10, 2025.

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1740175876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 NE REVERE AVE STE 150",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 NE REVERE AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014147",
            "telephone_number": "458-206-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "RYEANN",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-25-4874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

• Laurie Ann Martin, MD
• Luke A Martin, M.D.
• Miranda Lynn Martin
• Molly Martin
• Nicole Renee Martin
• Thomas Martin, RN
• Whitney C Martin, DNP, FNP-BC
• William G Martin, MD
• Belinda Martinez, LMT
• Nancy Marivel Martinez

All providers in Bend, OR · Addiction (Substance Use Disorder) Counselor in Oregon