Individual
AN RUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
875 OAK ST SE STE 5060, SALEM, OR 97301-3987
(033) 991-3865
(503) 399-1182
Mailing address
875 OAK ST. SE #5060, SALEM, OR 97301
(503) 399-1386
(503) 399-1182
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA206692
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2020
Last updated
07/21/2022
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