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Individual

DR. CHARA ELAINE RYDZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-0990
(503) 494-4982
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-0990
(503) 494-4982

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2016010398
MO
2085R0202X
Diagnostic Radiology Physician
Primary
MD189979
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1407176076
MO
05
ENROLLED
IL
Enumeration date
06/07/2010
Last updated
01/28/2019
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