Active NPI
Ryan Minarik, ND, LAC
- Naturopath
- Portland, OR
National Provider Identifier
1790829083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 1517
- Practice address
- 8113 SE 13TH Ave
Portland, OR 97202-6607 - Phone
- (503) 232-5653
- Fax
- (503) 234-6094
- NPI assigned
- Feb 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC01027 | OR | |
| Naturopath | 175F00000X | 1517 | OR | Primary |
Addresses
Primary practice location
8113 SE 13TH Ave
Portland, OR 97202-6607
Mailing address
8113 SE 13TH Ave
Portland, OR 97202-6607
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC01027 | OR | MD | Acupuncturist |
| 1517 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Form Health LLC | Acupuncturist | Current | Accepting new patients |
Locations
8113 SE 13th Ave
Portland, OR 97202
Phone (503) 232-5653
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643673600000",
"number": "1790829083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8113 SE 13TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972026607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8113 SE 13TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972026607",
"telephone_number": "503-232-5653",
"fax_number": "503-234-6094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINARIK",
"first_name": "RYAN",
"name_prefix": "Dr.",
"credential": "ND, LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-19",
"last_updated": "2022-02-01",
"certification_date": "2022-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "AC01027",
"primary": false
},
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "OR",
"license": "1517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.