Individual
DR. GRACE E JAZRAWI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4212 NE BROADWAY, PORTLAND, OR 97213-1422
(503) 249-8787
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MB09038900
NJ
207R00000X
Internal Medicine Physician
Primary
DO179357
OR
Other
Enumeration date
05/27/2009
Last updated
10/11/2017
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