Individual
MR. RYAN GREY EYTALIS-MAINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAT, LAT, ATC
Contact information
Practice address
909 SW 18TH AVE, PORTLAND, OR 97205-1705
(907) 240-8556
Mailing address
7952 SE ASPEN SUMMIT DR APT 150, PORTLAND, OR 97266-9212
(907) 240-8556
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/09/2020
Last updated
06/19/2024
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