Individual
LINA ROSSETTI-GRULICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-7162
Mailing address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
202009818NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500787482
—
OR
Enumeration date
11/06/2020
Last updated
02/03/2026
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