Individual
MICHELLE BRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 NE DIVISION ST STE 100, GRESHAM, OR 97030-4617
(503) 666-3808
Mailing address
4101 NE DIVISION ST STE 100, GRESHAM, OR 97030-4617
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201505254RN
OR
Other
Enumeration date
07/29/2016
Last updated
09/30/2016
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