Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ryan Wallenberg, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1114283561

Ryan Wallenberg, MD is a Student in an Organized Health Care Education/Training Program in Portland, Oregon. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone: (503) 494-8211
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1114283561
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 10, 2012
Last updated in NPPESApril 10, 2012
Mailing address1623 S Taverner Dr, Ridgefield, WA 98642

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