Individual
MIKAYLA GREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
6448 SE PINE ST, PORTLAND, OR 97215-1368
(831) 332-2288
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
11800756-3102
UT
163WC0200X
Critical Care Medicine Registered Nurse
Primary
202209027RN
OR
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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