Individual
ANNE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5005 NE 13TH AVE, PORTLAND, OR 97211-5079
(505) 660-8066
Mailing address
7125 N GREENWICH AVE, PORTLAND, OR 97217-5445
(505) 660-8066
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14758
OR
Other
Enumeration date
09/12/2009
Last updated
09/12/2009
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