Individual
MADELINE SIMON GRANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9000 N LOMBARD ST, PORTLAND, OR 97203-3006
(503) 988-5558
Mailing address
1001 POTRERO AVENUE, BLDG 80-83, SAN FRANCISCO, CA 94110-2859
(503) 860-2841
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200432
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/25/2013
Last updated
01/20/2021
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