Individual
GRANT R LINDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19250 SW 65TH AVE, SUITE 215, TUALATIN, OR 97062-7452
(503) 692-3630
(503) 692-3420
Mailing address
6420 S MACADAM AVE STE 160, PORTLAND, OR 97239-3517
(503) 244-8601
(503) 244-3013
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD13176
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215368
—
OR
Enumeration date
09/27/2005
Last updated
08/13/2020
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