Individual
RYAN D PEDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
(541) 266-4506
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 269-5151
(541) 266-4506
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DP151127
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500623170
—
OR
Enumeration date
08/21/2007
Last updated
03/30/2020
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