Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 10352893-1205 | UT |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD175458 | OR |
NPI | 1104183888 |
---|---|
Provider Name | Ryland Kagan |
First Address | Portland, OR 97202 |
Second Address | Portland, OR 97239-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2012 |
Last Update Date | 18/09/2017 |