Individual
DOUGLAS WILLIAM GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1151 MAY ST, SUITE 201, HOOD RIVER, OR 97031-1526
(541) 387-1300
(541) 386-6224
Mailing address
PO BOX 3390, PORTLAND, OR 97208-3390
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
9966
ND
207Q00000X
Family Medicine Physician
Primary
MD153379
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500690452
—
OR
Enumeration date
04/19/2007
Last updated
03/10/2021
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