Healthcare Provider Details

I. General information

NPI: 1669376315
Provider Name (Legal Business Name): GREGORY ROBERT ECK RRT, AE-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 SW US VETERANS HOSPITAL RD
PORTLAND OR
97239-2964
US

IV. Provider business mailing address

12865 SE 25TH AVE
OAK GROVE OR
97222-7990
US

V. Phone/Fax

Practice location:
  • Phone: 503-220-8262
  • Fax:
Mailing address:
  • Phone: 503-220-8262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279E1000X
TaxonomyEducational Registered Respiratory Therapist
License Number10166639
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: