Individual
MRS. ANTONIA LARISSA GRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3303 SW BOND AVE, CH8N, PORTLAND, OR 97239-4501
(503) 494-4314
(503) 346-6810
Mailing address
3303 SW BOND AVE, CH8N, PORTLAND, OR 97239-4501
(503) 494-4314
(503) 346-6810
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA153285
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356658512
—
WA
05
—
500635914
—
OR
Enumeration date
09/09/2010
Last updated
07/05/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us