Individual
KENTON W GREGORY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9155 SW BARNES RD, #204, PORTLAND, OR 97225-6625
(503) 297-0541
(503) 216-4079
Mailing address
PO BOX 821350, VANCOUVER, WA 98682-0030
(503) 283-5220
(503) 283-9527
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD17161
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029749
—
OR
Enumeration date
11/18/2005
Last updated
07/08/2007
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