Individual
STANLEY J CYRAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5330 NE GLISAN ST., SUITE 200, PORTLAND, OR 97213-3069
(503) 215-9080
(503) 215-9099
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3159
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD00039772
WA
207N00000X
Dermatology Physician
Primary
MD126216
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500609570
—
OR
05
—
8277832
—
WA
01
—
P00795105
RR MEDICARE
OR
Enumeration date
06/06/2006
Last updated
10/05/2020
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