Individual
TIFFANY A GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6605 SE LAKE RD, MILWAUKIE, OR 97222-2161
(503) 982-9300
Mailing address
6605 SE LAKE RD, MILWAUKIE, OR 97222-2161
(503) 655-8401
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201609693
OR
Other
Enumeration date
06/07/2018
Last updated
01/13/2025
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