Healthcare Provider Details

I. General information

NPI: 1740799519
Provider Name (Legal Business Name): ALEXANDER HADLEY RYDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 RIVERBEND DR
SPRINGFIELD OR
97477-8800
US

IV. Provider business mailing address

NORTHWEST ANESTHESIA PHYSICIANS, PC PO BOX 7247
SPRINGFIELD OR
97475-0011
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-5000
  • Fax: 312-942-8858
Mailing address:
  • Phone: 541-681-5124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberDO214281
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: