Healthcare Provider Details

I. General information

NPI: 1447884952
Provider Name (Legal Business Name): RYAN PAUL HOFER ND, LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2020
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 S MACADAM AVE STE 306
PORTLAND OR
97239-3927
US

IV. Provider business mailing address

2388 NW AVA AVE
GRESHAM OR
97030-2567
US

V. Phone/Fax

Practice location:
  • Phone: 503-224-0443
  • Fax:
Mailing address:
  • Phone: 971-724-7950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number5111
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number24406
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: