Individual
JAN GRENDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4805 NE GLISAN ST, SUITE 6N60, PORTLAND, OR 97213-2933
(503) 215-3258
(503) 215-3254
Mailing address
905 NE 47TH AVE, APT 1, PORTLAND, OR 97213-2226
(503) 215-3258
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
FE172129
OR
Other
Enumeration date
07/14/2015
Last updated
08/06/2015
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