Individual
GREGORY RYAN DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(503) 413-7711
Mailing address
20 MEDICAL VILLAGE DR STE 258, EDGEWOOD, KY 41017-5411
(859) 341-7246
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.369950
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
201604975CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
95001113
CA
367500000X
Certified Registered Nurse Anesthetist
COA.15521-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01316392
RR MEDICARE NUMBER
OH
Enumeration date
11/14/2013
Last updated
10/24/2025
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