MEDICARE: RYAN ANEST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1891535696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN ANEST

Provider Business Mailing Address
First Line	:	7695 SW 82ND AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97223-7326
Country	:	US
Telephone Number	:	360-584-5335
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 S STATE ST STE 4200
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-3977
Country	:	US
Telephone Number	:	503-636-3028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2024
Last Update Date	:	05/29/2024

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Directions to “ RYAN ANEST ” Practice Location

Language	Start Address	Practice Location

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