Grant, Mary E
Grant, Mary E is an individual health care provider with primary practice located at 10140 Sw Parkway , Portland OR 97225-5008. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Grant, Mary E can be contacted via phone (503) 215-2669.Contact Information
Primary practice address
10140 Sw Parkway
Portland OR 97225-5008
Phone: (503) 215-2669
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 077037862N3 | Oregon |
Profile Details
| NPI number | 1811989379 |
|---|---|
| LBN Legal business name | Grant, Mary E |
| Credentials | Adult Nurse Practitioner (ANP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2005 |
| Last updated | Feb 12th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811989379 | NPPES |
| Oregon | MEDICAID | 128111 |
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