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NPI Code Detail

MEDICARE: ANDREW LYNN TIGNOR-GRILE MINISTRY

MEDICARE:   ANDREW LYNN TIGNOR-GRILE  MINISTRY
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
1374K00000XReligious Nonmedical PractitionerHONORARYOR

General Provider Information

NPI Number : 1962103127
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW LYNN TIGNOR-GRILE MINISTRY
Provider Business Mailing Address
First Line : 18065 SE LAMPER CT
Second Line :
City : SANDY
State : OR
Zip : 97055-8301
Country : US
Telephone Number : 971-264-0314
Fax Number :
Provider Business Practice Location Address
First Line : 777 STANTON BLVD # 10612992
Second Line :
City : ONTARIO
State : OR
Zip : 97914-8335
Country : US
Telephone Number : 971-264-0314
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2023
Last Update Date : 03/15/2023

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Directions to “ ANDREW LYNN TIGNOR-GRILE MINISTRY” Practice Location

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