Provider Demographics
NPI:1861768400
Name:GLOVER, RYAN MILO (RPH)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:MILO
Last Name:GLOVER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:3700 PACIFIC HIGHWAY EAST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424
Mailing Address - Country:US
Mailing Address - Phone:253-382-6312
Mailing Address - Fax:253-382-6301
Practice Address - Street 1:3700 PACIFIC HIGHWAY EAST
Practice Address - Street 2:SUITE 100
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424
Practice Address - Country:US
Practice Address - Phone:253-382-6312
Practice Address - Fax:253-382-6301
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPH000176841835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology