Individual
DAGAN ADAIR GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS PT
Contact information
Practice address
702 SW RAMSEY AVE, SUITE 220, GRANTS PASS, OR 97527-5858
(541) 479-0765
(541) 479-3461
Mailing address
11481 SW HALL BLVD, SUITE 201, PORTLAND, OR 97223-8403
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6358
OR
225100000X
Physical Therapist
PT959
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116812600
—
WY
05
—
500626304
—
OR
01
—
P00877705
RR MEDICARE
OR
Enumeration date
07/31/2006
Last updated
02/07/2011
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