Individual
DR. GRACE E. CRARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
611 SW CAMPUS DR, RM. 805, PORTLAND, OR 97239-3001
(503) 494-0732
(503) 494-7931
Mailing address
611 SW CAMPUS DR, RM. 805, PORTLAND, OR 97239-3001
(503) 494-0732
(503) 494-7931
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5686
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149518
PERFORMING PROVIDER
—
05
—
202952
—
OR
Enumeration date
06/17/2013
Last updated
03/07/2023
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