Individual
RYAN ISHIHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
765 14TH ST NE, SALEM, OR 97301-2611
(808) 292-6907
(808) 292-6907
Mailing address
765 14TH ST NE, SALEM, OR 97301-2611
(503) 399-3241
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-10182504
OR
Other
Enumeration date
10/26/2017
Last updated
10/26/2017
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