Individual
JORI BETH GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6395 KEIZER STATION BLVD NE STE 101, KEIZER, OR 97303-2305
(971) 267-2033
Mailing address
15179 SW 84TH AVE, TIGARD, OR 97224-7580
(541) 556-6928
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10932
OR
Other
Enumeration date
11/04/2018
Last updated
11/04/2018
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