Individual
MR. ROBERT RAD GLEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
191 N MAIN ST, LEBANON, OR 97355-2870
(541) 451-7940
Mailing address
PO BOX 1193, CORVALLIS, OR 97339-1193
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA212619
OR
363A00000X
Physician Assistant
—
—
Other
Enumeration date
02/05/2022
Last updated
08/22/2022
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