Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 27-3110 | OR |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 4394 | CO |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 7912009-1202 | UT |
NPI | 1760429732 |
---|---|
Provider Name | Dr. Ryan M Thomas |
First Address | Happy Valley, OR 97086-8737 |
Second Address | Gresham, OR 97030-7449 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 25/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202562300 | U.S. DEPT OF LABOR (01) | OR |
U67185 | (02) | OR |