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Individual

MR. RYAN GABERIEL LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
501 E 1ST ST, NEWBERG, OR 97132-2909
(503) 538-4874
(503) 538-1271
Mailing address
PO BOX 636, NEWBERG, OR 97132-0636
(503) 538-4874
(503) 538-1271

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500625268
OR
Enumeration date
08/21/2012
Last updated
08/21/2012
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