Provider Demographics
NPI:1760996631
Name:GRAYBILL, ROBERT ALLEN (ND)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALLEN
Last Name:GRAYBILL
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7455 SW BRIDGEPORT RD STE E240
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7252
Mailing Address - Country:US
Mailing Address - Phone:503-344-1345
Mailing Address - Fax:503-465-3821
Practice Address - Street 1:7455 SW BRIDGEPORT RD
Practice Address - Street 2:ST. E240
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-7252
Practice Address - Country:US
Practice Address - Phone:503-344-1345
Practice Address - Fax:503-465-3821
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4139175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath