Healthcare Provider Details

I. General information

NPI: 1578251237
Provider Name (Legal Business Name): GRACE ANNE FITTING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 CAPITOL ST NE
SALEM OR
97301-0698
US

IV. Provider business mailing address

670 PALISADES DR SE
SALEM OR
97302-3979
US

V. Phone/Fax

Practice location:
  • Phone: 503-399-2424
  • Fax: 503-375-7432
Mailing address:
  • Phone: 808-724-9170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD227184
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: