Organization
PORTLAND ORAL AND FACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON GRESH (PRACTICE MANAGER)
(503) 525-3632
Entity
Organization
Contact information
Practice address
5050 NE HOYT ST STE 322, PORTLAND, OR 97213-2982
(503) 230-0322
(503) 230-0344
Mailing address
1849 NW KEARNEY ST STE 300, PORTLAND, OR 97209-1453
(503) 525-3632
(971) 279-4603
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
01/07/2026
Last updated
01/07/2026
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