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1720362882
KELLIE L GRAYBOSCH
PORTLAND, OR
NPI
1720362882
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR PA156616)
Enumeration Date
2011-10-06
Last Update Date
2021-03-10
Business Address
KELLIE L GRAYBOSCH PA-C
9427 SW BARNES RD STE 495
PORTLAND, OR 97225-6652
Phone number: 503-216-1661
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Mailing Address
KELLIE L GRAYBOSCH PA-C
PO BOX 3158
PORTLAND, OR 97208-3158
Phone number:
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