Individual
RYAN WHITWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2121 NE 139TH ST STE 205, VANCOUVER, WA 98686-2316
(503) 413-4488
Mailing address
PO BOX 2077, PORTLAND, OR 97208-2077
(503) 413-3900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
52172
CA
363A00000X
Physician Assistant
Primary
PA61553025
WA
Other
Enumeration date
11/26/2014
Last updated
06/04/2024
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