GRACE LAKE

NEWPORT, OR
NPI1124752233
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: OR  PA221993)
Enumeration Date2022-07-13
Last Update Date2024-11-08
Business Address
GRACE LAKE
930 SW ABBEY ST
NEWPORT, OR 97365-4820
Phone number: 541-265-2244
Mailing Address
GRACE LAKE
930 SW ABBEY ST
NEWPORT, OR 97365-4820
Phone number: