Individual
KEVIN J GRAINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16180 SE SUNNYSIDE RD STE 102, HAPPY VALLEY, OR 97015-6302
(503) 582-4900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD25381
OR
Other
Enumeration date
12/20/2006
Last updated
02/12/2021
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