Individual
ANDREW D GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
16770 SW EDY RD, SUITE 102, SHERWOOD, OR 97140-9678
(503) 215-9600
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO21335
OR
207Q00000X
Family Medicine Physician
OP00001849
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288469
—
OR
05
—
8463606
—
WA
01
—
P00946511
RR MEDICARE
OR
Enumeration date
05/19/2006
Last updated
12/10/2012
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