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General NPI Number Information
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NPI Number | 1629029921
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Entity Type | Individual
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Provider Name | FAYE GRIMMELL ANP/GNP
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Gender | Female
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 13200 SW PACIFIC HWY
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City | TIGARD
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State | OR
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Zip | 97223
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Country | US
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Telephone | 503-598-2000
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Fax | 503-639-0920
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Provider Business Mailing Address
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Address Line | 6 CENTERPOINTE DR STE 200
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-8660
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Country | US
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Telephone | 503-797-2273
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Fax | 503-234-8155
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 081001262N3
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License Number State | OR
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