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1245485846
GRETA LOUISE MIRACLE
VANCOUVER, WA
NPI
1245485846
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WA 60058267)
Enumeration Date
2008-11-24
Last Update Date
2008-11-24
Business Address
-- GRETA LOUISE MIRACLE PA-C
16703 SE MCGILLIVRAY BLVD
VANCOUVER, WA 98683-4300
Phone number: 360-566-4840
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Mailing Address
-- GRETA LOUISE MIRACLE PA-C
405 NE 80TH AVE
PORTLAND, OR 97213-7019
Phone number: 206-313-1113
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