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Individual

MR. SHAWN CHRISTOPHER GRIMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSPT

Contact information

Practice address
283 NW MILLER AVE, GRESHAM, OR 97030-7260
(503) 666-7644
(503) 674-9980
Mailing address
16083 SW UPPER BOONES FERRY RD, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60017
OR
225100000X
Physical Therapist
8118
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500699445
OR
01
990070610
RPN
CO
Enumeration date
01/17/2006
Last updated
05/13/2016
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