Individual
MRS. STEPHANIE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-2042
Mailing address
PO BOX 4399, PORTLAND, OR 97208-4399
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
042.0014074
VT
208000000X
Pediatrics Physician
Primary
MD202119
OR
Other
Enumeration date
06/26/2013
Last updated
10/15/2020
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