Individual
RYAN DUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3001 DAGGETT AVE STE 101, KLAMATH FALLS, OR 97601-1126
(541) 274-3278
(541) 274-3275
Mailing address
PO BOX 2120, PORTLAND, OR 97208-2120
(541) 274-3278
(541) 274-3275
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5236
AZ
363AS0400X
Surgical Physician Assistant
Primary
PA170495
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
753034
—
AZ
Enumeration date
10/01/2012
Last updated
11/04/2022
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