Individual
JOHN KENNETH GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2460 NE GRIFFIN OAKS ST, SUITE D1000, HILLSBORO, OR 97124-2672
(360) 213-1301
Mailing address
1409 FRANKLIN ST, SUITE 103, VANCOUVER, WA 98660-2899
(360) 213-1301
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10003835
WA
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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