Healthcare Provider Details

I. General information

NPI: 1457357576
Provider Name (Legal Business Name): BEATA L RYDZIK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 NE RAY CIR STE 200
HILLSBORO OR
97124-6313
US

IV. Provider business mailing address

5920 NE RAY CIR STE 200
HILLSBORO OR
97124-6313
US

V. Phone/Fax

Practice location:
  • Phone: 503-297-3440
  • Fax: 503-297-4584
Mailing address:
  • Phone: 503-297-3440
  • Fax: 503-297-4584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberMD25039
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD25039
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207NI0002X
TaxonomyClinical & Laboratory Dermatological Immunology Physician
License NumberMD00043352
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberMD00043352
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD00043352
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberMD00043352
License Number StateWA
# 7
Primary TaxonomyN
Taxonomy Code207NI0002X
TaxonomyClinical & Laboratory Dermatological Immunology Physician
License NumberMD25039
License Number StateOR
# 8
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberMD25039
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: