Organization
KAISER PERMANENTE
Active
Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EEVA SISKO GRAY RD, CDE (RENAL DIETITIAN/DIABETES EDUCATOR)
(503) 786-1149
Entity
Organization
Contact information
Practice address
8836 SW 49TH AVE, PORTLAND, OR 97219-3371
(503) 245-1866
Mailing address
8836 SW 49TH AVE, PORTLAND, OR 97219-3371
(503) 245-1866
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
826
OR
Other
Enumeration date
05/16/2008
Last updated
06/01/2021
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