Individual
GRANT A JOLLIFFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
70 BOWER DR, MEDFORD, OR 97501-3689
(541) 734-3430
(541) 734-3638
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 734-3430
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201903972NP-PP
OR
Other
Enumeration date
09/17/2019
Last updated
03/18/2021
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