Individual
MS. ASHLEY M GRUENHAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-5472
(541) 768-5111
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4182-23
WI
363A00000X
Physician Assistant
Primary
PA217403
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134647142
—
WI
Enumeration date
08/30/2017
Last updated
12/20/2023
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