Individual
JONATHAN RAY GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3460
(503) 643-7565
Mailing address
3755 NE SUMNER ST, PORTLAND, OR 97211
(503) 380-6354
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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