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RYAN WALLENBERG M.D.
NPI 1114283561
Student in an Organized Health Care Education/Training Program in Portland, OR

Active since April 10, 2012PECOS Enrolled
3181 SW SAM JACKSON PARK ROAD, PORTLAND, OR 97239(503) 494-8211 Get Directions Write a Review

NPPES record last updated: April 10, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ryan Wallenberg M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RYAN WALLENBERG M.D. (NPI 1114283561) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114283561
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameRYAN WALLENBERGCredential: M.D.
Location Address3181 SW SAM JACKSON PARK ROADPortland, OR 97239
Mailing Address1623 S Taverner DrRidgefield, WA 98642
Phone(503) 494-8211
Sole ProprietorNo
Enumeration DateApril 10, 2012
✔ NPI 1114283561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3181 SW SAM JACKSON PARK ROAD, Portland, OR 97239
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ryan Wallenberg M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MATTHEW JUDGE M.D.
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK ROAD, OREGON HEALTH & SCIENCE UNIVERSITY
PORTLAND, OR 97239
Multnomah County (503) 494-8144
MEGAN FURNARI M.D., M.S.
Pediatrics (Neonatal-Perinatal Medicine)
3181 SW SAM JACKSON PARK ROAD
PORTLAND, OR 97239
Multnomah County (503) 494-8211
MS. CHERYL DAWN MELZER PT
Physical Therapist
3181 SW SAM JACKSON PARK ROAD
PORTLAND, OR 97239
Multnomah County (503) 494-4998
NATHAN RICHARD SCHOENECK MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK ROAD, OHSU,
PORTLAND, OR 97239
Multnomah County (503) 494-8211
EMILY LAUREN PATON
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK ROAD
PORTLAND, OR 97239
Multnomah County (503) 494-8211
DR. LAURA ANN RYAN M.D.
Emergency Medicine
3181 SW SAM JACKSON PARK ROAD, CB 550
PORTLAND, OR 97239
Multnomah County (503) 494-2595
DR. JENNIFER LYNN FILE MCCALL DO
Pediatrics
3181 SW SAM JACKSON PARK ROAD
PORTLAND, OR 97239
Multnomah County (503) 494-1303
RYAN CHENG
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK ROAD
PORTLAND, OR 97239
Multnomah County (503) 494-8211

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ryan Wallenberg's NPI number?

The NPI number for Ryan Wallenberg is 1114283561. It was assigned to this individual provider in the NPPES registry on April 10, 2012.

Where is Ryan Wallenberg located?

Ryan Wallenberg practices at 3181 SW Sam Jackson Park Road, Portland, OR 97239. The listed phone number is (503) 494-8211.

What is Ryan Wallenberg's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ryan Wallenberg enrolled in Medicare?

Yes. Ryan Wallenberg is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ryan Wallenberg was last updated on April 10, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.