SHANTI RYAN PA-C NPI 1629884325

NPI Information

  • NPI: 1629884325
  • Provider Name: SHANTI RYAN, PA-C
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3822 SE POWELL BLVD
    PORTLAND, OR
    ZIP 97202
  • Phone: (888) 227-3312

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NPI Details

Shanti Ryan, PA-C is a student in an organized health care education training program in Portland, OR. The provider is 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. Shanti Ryan, PA-C NPI is 1629884325. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3822 SE POWELL BLVD
PORTLAND, OR
ZIP 97202-720
Phone: (888) 227-3312
Fax: (503) 717-9966

The NPI 1629884325 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/6/2024 and was last updated on 11/4/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantNo
2390200000XStudent in an Organized Health Care Education/Training ProgramYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11234509OTHERWASHINGTONCERTIFICATION
2PA70046563OTHERWASHINGTONLICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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