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Individual

MS. KATHLEEN GREGORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
130 NW 6TH ST, SUITE A, MCMINNVILLE, OR 97128-5582
(503) 775-4931
(503) 788-7285
Mailing address
3727 NE MARTIN LUTHER KING JR BLVD, ATTN: CREDENTIALING, PORTLAND, OR 97212-1112
(503) 775-4931
(503) 788-7285

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
080044677NP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
231860
OR
05
9655952
WA
Enumeration date
01/06/2007
Last updated
12/06/2011
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