Individual
DR. GLEN RITCHIE STREAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12518 NE AIRPORT WAY, PORTLAND, OR 97230-1078
(503) 256-2992
(503) 258-0717
Mailing address
12518 NE AIRPORT WAY, CONCENTRA MEDICAL CENTERS, PORTLAND, OR 97230
(503) 256-2992
(503) 258-0717
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD13357
OR
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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