Individual
KENRIC BRION CRAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
18040 SW LOWER BOONES FERRY RD, TIGARD, OR 97224-7258
(503) 216-0700
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01296
OR
363AM0700X
Medical Physician Assistant
PA01296
OR
Other
Enumeration date
09/04/2007
Last updated
10/06/2020
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