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Individual

DANA ROBERT GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
2222 NW LOVEJOY ST, SUITE 315, PORTLAND, OR 97210-3033
(503) 226-6101
(503) 227-3422
Mailing address
975 SE SANDY BLVD, SUITE 200, PORTLAND, OR 97214-1308
(503) 963-2846
(503) 963-9505

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00255
OR
363AS0400X
Surgical Physician Assistant
PA10003194
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500603161
OR
05
8434433
WA
Enumeration date
08/19/2005
Last updated
04/18/2011
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