Individual
RYAN DOUGLAS GLOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L, CHT
Contact information
Practice address
24076 SE STARK ST, STE 200, GRESHAM, OR 97030-3373
(503) 491-1666
(503) 491-1667
Mailing address
PO BOX 2485, GRESHAM, OR 97030-0660
(503) 674-7860
(503) 674-7642
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1023386
OR
225XH1200X
Hand Occupational Therapist
Primary
1041100414
OR
Other
Enumeration date
05/12/2006
Last updated
01/06/2009
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