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Individual

DR. THOMAS GRACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
5125 SW MACADAM AVE, #210, PORTLAND, OR 97239-3820
(503) 684-9698
Mailing address
5125 SW MACADAM AVE, #210, PORTLAND, OR 97239-3820
(503) 684-9698

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5740
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5740
OBCE
OR
Enumeration date
08/31/2016
Last updated
08/31/2016
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