Individual
JOEL THOMAS GRAY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
AT/R
Contact information
Practice address
6300 SW NICOL RD, PORTLAND, OR 97223-7566
(503) 416-9358
(503) 297-1105
Mailing address
8836 SW 49TH AVE, PORTLAND, OR 97219-3371
(503) 245-1866
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-550954
OR
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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