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NPI Code Detail

MEDICARE: MICHELLE GRIMES

MEDICARE: MICHELLE GRIMES
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
1225X00000XOccupational Therapist213930OR

General Provider Information

NPI Number : 1609002427
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE GRIMES
Provider Business Mailing Address
First Line : 5330 NE PRESCOTT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97218-2158
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5330 NE PRESCOTT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97218-2158
Country : US
Telephone Number : 503-288-6585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2009
Last Update Date : 06/08/2009

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Directions to “ MICHELLE GRIMES ” Practice Location

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