Individual
MR. MATTHEW GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3944 N MISSISSIPPI AVE, PORTLAND, OR 97227-1163
(503) 517-8222
(503) 517-8223
Mailing address
2718 SW FAIRVIEW BLVD, PORTLAND, OR 97205-5825
(503) 709-5898
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
11368
OR
Other
Enumeration date
12/10/2008
Last updated
12/10/2008
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