Provider Demographics
NPI:1932527199
Name:CONSTANTINE, RYAN (MD, PHD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:CONSTANTINE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 SW UMATILLA AVE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-7197
Mailing Address - Country:US
Mailing Address - Phone:541-548-7170
Mailing Address - Fax:541-548-3842
Practice Address - Street 1:1775 SW UMATILLA AVE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-7197
Practice Address - Country:US
Practice Address - Phone:541-548-7170
Practice Address - Fax:541-548-3842
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD198201207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist