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NPI Code Detail

MEDICARE: MOLLY LEORA GRIMSHAW

MEDICARE: MOLLY LEORA GRIMSHAW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171400000XHealth & Wellness Coach
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1518841485
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY LEORA GRIMSHAW
Provider Business Mailing Address
First Line : 5019 NE 14TH PL
Second Line :
City : PORTLAND
State : OR
Zip : 97211-4403
Country : US
Telephone Number : 415-599-9082
Fax Number :
Provider Business Practice Location Address
First Line : 14725 SE RHONE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97236-2556
Country : US
Telephone Number : 971-314-0144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2025
Last Update Date : 05/22/2026

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Directions to “ MOLLY LEORA GRIMSHAW ” Practice Location

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