Individual
MS. MARYANN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
850 W ANTLER AVE, REDMOND, OR 97756-2129
(541) 316-2041
Mailing address
PO BOX 1108, ACP 0016-07, SALEM, OR 97308-1108
(541) 447-5877
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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