Healthcare Provider Details

I. General information

NPI: 1841769114
Provider Name (Legal Business Name): SPINE CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2018
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 25TH ST SE STE 400
SALEM OR
97302-1284
US

IV. Provider business mailing address

2601 25TH ST SE STE 400
SALEM OR
97302-1284
US

V. Phone/Fax

Practice location:
  • Phone: 503-362-5555
  • Fax: 503-362-7250
Mailing address:
  • Phone: 503-362-5555
  • Fax: 503-362-7250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. RYAN EDWARD SCHIRMER
Title or Position: PRESIDENT
Credential: DC
Phone: 503-362-5555