MEDICARE: MARION GREGOR AND ASSOCIATES, 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	1041C0700X	Clinical Social Worker	2407	OR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	117226	OTHER	OR	MEDICARE GROUP

General Provider Information

NPI Number	:	1730353236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARION GREGOR AND ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	213 WATER AVE NW
Second Line	:	SUITE 400
City	:	ALBANY
State	:	OR
Zip	:	97321-2298
Country	:	US
Telephone Number	:	541-812-1242
Fax Number	:	541-928-1678

Provider Business Practice Location Address
First Line	:	213 WATER AVE NW
Second Line	:	SUITE 400
City	:	ALBANY
State	:	OR
Zip	:	97321-2298
Country	:	US
Telephone Number	:	541-812-1242
Fax Number	:	541-928-1678

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARION ELIZABETH GREGOR
Credential	:	MSW, LCSW
Telephone Number	:	541-812-1242

Provider Enumeration Date	:	04/15/2008
Last Update Date	:	04/15/2008

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