Most Relevant Information
Provider Data
| NPI Number: | 1003284738 |
| Provider Name: | RYAN OTTO MACHERAS CRM |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/11/2015 |
| Last Updated: | 09/11/2015 |
Provider Practice Location
10564 SE WASHINGTON ST
PORTLAND
OR
972162809
Practice Location Phone/Fax
| Phone: | 5035029487 |
| Fax: | 5032289558 |
Provider Mailing Location
10564 SE WASHINGTON ST
PORTLAND
OR
972162809
Provider Mailing Phone/Fax
| Phone: | 5035029487 |
| Fax: | 5032289558 |