Healthcare Provider Details

I. General information

NPI: 1760996631
Provider Name (Legal Business Name): ROBERT ALLEN GRAYBILL ND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 SE CESAR ESTRADA CHAVEZ BOULEVARD
PORTLAND OR
97214-4322
US

IV. Provider business mailing address

1330 SOUTHEAST CESAR ESTRADA CHAVEZ BLVD.
PORTLAND OR
97214-4322
US

V. Phone/Fax

Practice location:
  • Phone: 503-232-1100
  • Fax: 503-232-7751
Mailing address:
  • Phone: 503-232-1100
  • Fax: 503-232-7751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number4139
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: