MEDICARE: RYAN POPKIN M.A., LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	131367	CA
2	106H00000X	Marriage & Family Therapist	T2162	OR

General Provider Information

NPI Number	:	1912303025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN POPKIN M.A., LMFT

Provider Business Mailing Address
First Line	:	1020 SW TAYLOR ST STE 448
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97205-2509
Country	:	US
Telephone Number	:	805-709-1620
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 SW TAYLOR ST STE 448
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97205-2509
Country	:	US
Telephone Number	:	971-394-9249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	02/28/2023

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