Provider Demographics
NPI:1588931869
Name:CLEVEN, RYAN P (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:P
Last Name:CLEVEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 NE 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5975
Mailing Address - Country:US
Mailing Address - Phone:503-681-8640
Mailing Address - Fax:503-648-2255
Practice Address - Street 1:888 NE 25TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5975
Practice Address - Country:US
Practice Address - Phone:503-681-8640
Practice Address - Fax:503-648-2255
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0011820183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR214268OtherNABP