Individual
CARL ANTHONY RIDDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9427 SW BARNES RD STE 296, PORTLAND, OR 97225-6667
(503) 297-3778
(503) 297-7853
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD20646
OR
207RP1001X
Pulmonary Disease Physician
Primary
MD20646
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150111
—
OR
05
—
2017144
—
WA
Enumeration date
06/22/2006
Last updated
11/23/2021
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