Healthcare Provider Details

I. General information

NPI: 1427771625
Provider Name (Legal Business Name): MAYA RIOS ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4035 SE 52ND AVE STE B
PORTLAND OR
97206-3913
US

IV. Provider business mailing address

4246 SE BELMONT ST STE 5
PORTLAND OR
97215-1676
US

V. Phone/Fax

Practice location:
  • Phone: 971-229-2140
  • Fax: 971-233-6416
Mailing address:
  • Phone: 503-445-8114
  • Fax: 503-445-1394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number4467
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC222326
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: