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NPI Code Detail

MEDICARE: GRACE ANNE CHAMBERLAIN

MEDICARE: GRACE ANNE CHAMBERLAIN
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
1363AM0700XMedical Physician Assistant

General Provider Information

NPI Number : 1609490267
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE ANNE CHAMBERLAIN
Provider Business Mailing Address
First Line : 13000 SW 2ND ST
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-2615
Country : US
Telephone Number : 503-734-9218
Fax Number :
Provider Business Practice Location Address
First Line : 115 NE MAY LN
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-9272
Country : US
Telephone Number : 503-472-1338
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2020
Last Update Date : 02/04/2026

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Directions to “ GRACE ANNE CHAMBERLAIN ” Practice Location

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