Individual
MR. GRAHAM MICHAEL GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1755 SW BAKER ST, MCMINNVILLE, OR 97128-9112
(971) 900-4522
(971) 900-4503
Mailing address
600 JEFFERSON ST STE 600, LAFAYETTE, LA 70501-6987
(458) 201-5074
(337) 465-4604
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
202109761NP
OR
363LF0000X
Family Nurse Practitioner
Primary
202109761NP-PP
OR
363LF0000X
Family Nurse Practitioner
AP61241707
WA
Other
Enumeration date
11/03/2021
Last updated
11/04/2025
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