Individual
DOMINIQUE GRECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
725 S. WAHANNA RD, SEASIDE, OR 97138-7735
(503) 717-7556
(503) 717-7476
Mailing address
PO BOX 3397, PORTLAND, OR 97208-3397
(503) 215-6646
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD22648
OR
207Q00000X
Family Medicine Physician
MD61664618
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288248
—
OR
Enumeration date
09/20/2006
Last updated
05/02/2025
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