BRYAN GARY JAMES ROTH

PORTLAND, OR
NPI1750050001
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: OR  PA207736)
Additional Taxonomies363A00000X Physician Assistant
363A00000X Physician Assistant
(Licence: OR  PA207736)
Enumeration Date2021-09-09
Last Update Date2025-05-27
Business Address
BRYAN GARY JAMES ROTH
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 503-494-1775
Mailing Address
BRYAN GARY JAMES ROTH
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 503-494-1775