Individual
ROXANNE RUYLE GRISWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4805 NE GLISAN ST, STE 6N40, PORTLAND, OR 97213-2933
(503) 215-5696
(503) 215-5695
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20005003NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100121
—
OR
Enumeration date
08/18/2005
Last updated
02/12/2021
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