Individual
RYAN BRENT UDINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6051 W EMERALD ST, BOISE, ID 83704-8969
(208) 302-5150
(208) 302-5155
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 302-9342
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
010492
OH
207P00000X
Emergency Medicine Physician
7281913
ID
207P00000X
Emergency Medicine Physician
Primary
DO160999
OR
Other
Enumeration date
04/15/2009
Last updated
06/29/2026
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