Individual
MICHAEL THOMAS GRANATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239
(503) 494-8311
Mailing address
5308 213TH ST, BAYSIDE HILLS, NY 11364-1824
(917) 597-9066
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA194278
OR
Other
Enumeration date
07/14/2014
Last updated
11/12/2019
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