Individual
NICOLE ELISA GREGOIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 N GRAHAM ST STE 125, PORTLAND, OR 97227-1683
(503) 413-3714
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
OR
Other
Enumeration date
08/28/2020
Last updated
06/06/2024
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