Individual
CARLY JANE KING GRAVEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-6594
(503) 494-5385
Mailing address
1400 SW 5TH AVE STE 500, PORTLAND, OR 97201-5537
(866) 617-6855
(503) 346-8015
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
58259
CA
363AM0700X
Medical Physician Assistant
Primary
PA207931
OR
Other
Enumeration date
05/21/2019
Last updated
09/18/2025
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