| NPI | 1780390864 |
|---|---|
| Doing Business As | THE JACKSON MACY CLINIC |
| Entity Type | Organization |
| Authorized Contact | KELLY GRANT Owner 503-724-8188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-11-21 |