Childers, Ryan Edwin

Childers, Ryan Edwin is an individual health care provider with primary practice located at 19250 Sw 90Th Ave , Tualatin OR 97062-7585. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Childers, Ryan Edwin can be contacted via phone (503) 692-3750.

Contact Information

Primary practice address
19250 Sw 90Th Ave Tualatin OR 97062-7585
Phone: (503) 692-3750
Fax: (503) 691-2324
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X D74059 Maryland
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MD162161 Oregon

Profile Details

NPI number 1568627594
LBN Legal business name Childers, Ryan Edwin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2008
Last updated Feb 1st, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568627594 NPPES
Oregon MEDICAID 500678079
Oregon MEDICAID 055765000

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