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NPI Code Detail

MEDICARE: DR. KATHY GREWE MD

MEDICARE: DR. KATHY GREWE MD
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
1207RC0000XCardiovascular Disease PhysicianMD16646OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407851454
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHY GREWE MD
Provider Business Mailing Address
First Line : PO BOX 3390
Second Line :
City : PORTLAND
State : OR
Zip : 97208-3390
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1304 MONTELLO AVE
Second Line :
City : HOOD RIVER
State : OR
Zip : 97031-1544
Country : US
Telephone Number : 541-387-6125
Fax Number : 541-387-6315
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 11/22/2016

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Directions to “ DR. KATHY GREWE MD” Practice Location

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