Provider Demographics
NPI:1053404020
Name:RYAN, LAURA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANN
Last Name:RYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1920 SW RIVER DR UNIT 806
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-8050
Mailing Address - Country:US
Mailing Address - Phone:503-314-2542
Mailing Address - Fax:503-494-4980
Practice Address - Street 1:3181 SW SAM JACKSON PARK ROAD
Practice Address - Street 2:CB 550
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3098
Practice Address - Country:US
Practice Address - Phone:503-494-2595
Practice Address - Fax:503-494-4980
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR25575207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine