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Individual

GRAHAM D GLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
222 NE PARK PLAZA DR, SIUTE 100, VANCOUVER, WA 98684-5895
(360) 254-8025
(360) 254-8618
Mailing address
PO BOX 1517, PENDLETON, OR 97801-0410
(877) 708-1119
(541) 278-8349

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00037803
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110187987
RAILROAD MEDICARE
WA
05
8244923
WA
Enumeration date
06/21/2006
Last updated
12/30/2022
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