Individual
RYAN GEORGE MAIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2850 SE POWELL VALLEY RD STE 205, GRESHAM, OR 97080-1489
(503) 489-1975
Mailing address
2850 SE POWELL VALLEY RD STE 205, GRESHAM, OR 97080-1489
(503) 489-1975
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6263
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6263
STATE LICENSE
OR
Enumeration date
12/07/2022
Last updated
12/07/2022
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