Individual
DR. CANDACE LYNN GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
14795 SW MURRAY SCHOLLS DR STE 121, BEAVERTON, OR 97007-9713
(503) 597-5647
(503) 597-5640
Mailing address
14795 SW MURRAY SCHOLLS DR STE 121, BEAVERTON, OR 97007-9713
(503) 597-5647
(503) 597-5640
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00367
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902813066
RAILROAD MEDICARE
OR
Enumeration date
08/02/2006
Last updated
08/25/2010
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