Individual
KIMBERLY C GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5050 NE HOYT ST STE 256, PORTLAND, OR 97213-2982
(503) 239-7767
(503) 215-6897
Mailing address
1498 SE TECH CENTER PL STE 240, VANCOUVER, WA 98683-5508
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA179181
OR
363AS0400X
Surgical Physician Assistant
PA179181
OR
Other
Enumeration date
09/26/2016
Last updated
11/04/2024
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