Ryan D Pederson
Foot & Ankle Surgery
1900 Woodland Dr
Coos Bay
, Oregon 97420-2099
Ryan D Pederson
Foot & Ankle Surgery
1900 Woodland Dr
Coos Bay
, Oregon 97420-2099
(541) 266-4506
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About
Features
Specialties
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- Ryan D Pederson
- 1900 Woodland Dr
- Coos Bay, OR
- Zip : 97420-2099
- Fax : (541) 266-4506
- Phone : (541) 269-5151
Second Address
- Ryan D Pederson
- 1900 Woodland Dr
- Coos Bay, OR
- Zip : 97420-2099
- Fax : (541) 266-4506
- Phone : (541) 267-5151
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0103X | Foot & Ankle Surgery | DP151127 | OR |
National Provider Identifier
| NPI | 1063605384 |
|---|---|
| Provider Name | Ryan D Pederson |
| First Address | Coos Bay, OR 97420-2099 |
| Second Address | Coos Bay, OR 97420-2099 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/08/2007 |
| Last Update Date | 30/03/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 500623170 | (05) | OR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.