Individual
MATTHEW GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 NW 23RD AVE, PORTLAND, OR 97210-2906
(503) 413-7074
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(508) 776-2463
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
DO222984
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2018
Last updated
12/11/2024
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