Individual
GRACE TUDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
24076 SE STARK ST STE 110, GRESHAM, OR 97030-3374
(503) 661-5388
(503) 666-9393
Mailing address
24076 SE STARK ST STE 110, GRESHAM, OR 97030-3374
(503) 661-5388
(503) 666-9393
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA227904
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/07/2024
Last updated
05/13/2026
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