MEDICARE: ADAMS & GRAY, INC

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
1	251E00000X	Home Health Agency	13-1382	OR

General Provider Information

NPI Number	:	1083611818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAMS & GRAY, INC

Provider Business Mailing Address
First Line	:	4560 SE INTERNATIONAL WAY STE 100
Second Line	:
City	:	MILWAUKIE
State	:	OR
Zip	:	97222-4628
Country	:	US
Telephone Number	:	971-206-5212
Fax Number	:	971-206-5213

Provider Business Practice Location Address
First Line	:	4560 SE INTERNATIONAL WAY STE 100
Second Line	:
City	:	MILWAUKIE
State	:	OR
Zip	:	97222-4628
Country	:	US
Telephone Number	:	971-206-5212
Fax Number	:	971-206-5213

Authorized Official
Title or Position	:	CONTROLLER
Name	:	STACI TONE
Credential	:
Telephone Number	:	971-206-5125

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	01/19/2021

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Directions to “ADAMS & GRAY, INC ” Practice Location

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