Provider Demographics
NPI:1740521988
Name:GRENIER, DONNA LOUISE (RN)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LOUISE
Last Name:GRENIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8809 SW 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-3453
Mailing Address - Country:US
Mailing Address - Phone:503-452-0493
Mailing Address - Fax:503-452-0360
Practice Address - Street 1:1413 E ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OR
Practice Address - Zip Code:97008
Practice Address - Country:US
Practice Address - Phone:503-452-0493
Practice Address - Fax:503-452-0360
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR085069871RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse