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General NPI Number Information
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NPI Number | 1912303025
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Entity Type | Individual
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Provider Name | RYAN POPKIN M.A., LMFT
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Gender | Male
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 1020 SW TAYLOR ST STE 448
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City | PORTLAND
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State | OR
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Zip | 97205-2509
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Country | US
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Telephone | 971-394-9249
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 SW TAYLOR ST STE 448
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City | PORTLAND
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State | OR
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Zip | 97205-2509
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Country | US
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Telephone | 805-709-1620
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 131367
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T2162
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License Number State | OR
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