Individual
DR. MARY GRACE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
506 4TH ST., GRANDE RONDE HOSPITAL REGIONAL MEDICAL CLINIC, LA GRANDE, OR 97850
(541) 663-3138
(541) 975-5120
Mailing address
506 4TH ST., LA GRANDE, OR 97850
(541) 663-3138
(541) 975-5120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO28026
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218112
—
OR
Enumeration date
01/17/2008
Last updated
06/22/2021
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