Individual
RYAN HOWARD LEA-BOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3540 SE FRANCIS ST, PORTLAND, OR 97202-3350
(503) 232-5767
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09659
OR
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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