Individual
MICHELLE ELISABETH GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
800 SW 13TH AVE, PORTLAND, OR 97205
(503) 221-0161
(503) 221-4451
Mailing address
800 SW 13TH AVE, PORTLAND, OR 97205
(503) 221-0161
(503) 221-4451
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
089007574N3
OR
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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