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Individual

GRISELDA VELASCO LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1175 MOUNT HOOD AVE, WOODBURN, OR 97071-9060
(503) 982-2000
Mailing address
1175 MOUNT HOOD AVE, WOODBURN, OR 97071-9060
(503) 982-2000
(503) 982-0660

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA214715
OR
363AM0700X
Medical Physician Assistant

Other

Enumeration date
01/18/2023
Last updated
03/27/2023
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