Individual
TARA LEE GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239
(503) 803-4860
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 803-4860
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
093006523N1 FNP
OR
Other
Enumeration date
02/12/2007
Last updated
06/24/2011
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