ANTONIA LARISSA GRAGG

PORTLAND, OR
NPI1356658512
Former NameANTONIA LARISSA SOINEY
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: OR  PA153285)
Enumeration Date2010-09-09
Last Update Date2013-07-05
Business Address
Mrs. ANTONIA LARISSA GRAGG PA-C
3303 SW BOND AVE CH8N
PORTLAND, OR 97239-4501
Phone number: 503-494-4314
Mailing Address
Mrs. ANTONIA LARISSA GRAGG PA-C
3303 SW BOND AVE CH8N
PORTLAND, OR 97239-4501
Phone number: 503-494-4314