Individual
MR. GRADY VENSON RAPIER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 249-3429
Mailing address
PO BOX 219201, PORTLAND, OR 97225-9201
(503) 249-3429
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO00000782
WA
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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