Individual
ANNE MARIE GLOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-0996
Mailing address
3181 SW SAM JACKSON PARK RD., EP LAB, PORTLAND, OR 97239-3011
(503) 494-0996
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA156763
OR
363AM0700X
Medical Physician Assistant
PA156763
OR
363AS0400X
Surgical Physician Assistant
PA156763
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500642227
—
OR
Enumeration date
01/10/2012
Last updated
09/20/2023
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