Individual
SHELLY ANN GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMA
Contact information
Practice address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-4947
Mailing address
21621 LOGSDEN RD, BLODGETT, OR 97326-9343
(503) 451-1969
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
728012
OR
Other
Enumeration date
04/03/2024
Last updated
02/27/2025
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