Individual
GREGORY PAUL FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
093000555
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5462544
DRIVERS LICENSE
OR
Enumeration date
07/25/2022
Last updated
07/25/2022
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