Friess, Malin Grady

Friess, Malin Grady is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Friess, Malin Grady can be contacted via phone (503) 494-8916.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Portland OR 97239-3011
Phone: (503) 494-8916
Fax: (503) 494-0294
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DD3441 New Mexico
Dental Providers / General Practice 1223G0001X D9065 Oregon

Profile Details

NPI number 1609866292
LBN Legal business name Friess, Malin Grady
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Mar 5th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609866292 NPPES
New Mexico Other DD3441 STATE LICENSE

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