DR. GRAYDEN WOODRUFF KING (NPI# 1851587364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851587364 |
| Entity Type | Individual |
| Full Name | DR. GRAYDEN WOODRUFF KING |
| Credential | D.P.M |
| Practice Address |
831 Nw Council Dr Ste 203 Gresham OR 97030-3721 |
| Practice Telephone | 5036676600 |
| Practice Fax Number | 5036676608 |
| Mailing Telephone | 5036676600 |
| Mailing Fax Number | 5036676608 |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2017-12-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
DP 00436 | OR | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | MEDICARE PTAN | R141926 | 01 |
| TX | 377694001 | 05 | |
| TX | 377694002 | 05 |
| Street Address |
831 NW COUNCIL DR STE 203 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-3721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992798169 | Timothy L Kelly | Anesthesiology | 831 Nw Council Dr, Suite 300, Gresham, OR 97030-3721 | 2005-08-23 |
| 1821341223 | Columbia Pain and Spine Institute | Clinical Medical Laboratory | 831 Nw Council Dr, #300, Gresham, OR 97030 | 2012-10-23 |
| 1750643060 | John C. Anderson, M.d., P.C. | Orthopaedic Surgery | 831 Nw Council Dr, Suite 130, Gresham, OR 97030-3721 | 2012-06-12 |
| 1053699645 | Whitney Blaire Fancher | Dermatology | 831 Nw Council Dr, Suite 301, Gresham, OR 97030-3721 | 2011-07-30 |
| 1386897809 | Maria S Kling | Nurse Practitioner | 831 Nw Council Dr, Suite 101, Gresham, OR 97030-3721 | 2008-10-28 |
| 1932376894 | Sarah Schultz | Internal Medicine | 831 Nw Council Dr, Suite 125, Gresham, OR 97030-3721 | 2008-05-09 |
| 1649442476 | Melanie Marie Falgout | Family Medicine | 831 Nw Council Dr, Suite 125, Gresham, OR 97030-3721 | 2008-04-01 |
| 1639352594 | Rose City Breast Care, LLC | Surgery | 831 Nw Council Dr, Suite 301, Gresham, OR 97030-3721 | 2007-12-13 |
| 1720278633 | Karen Shaw | Nurse Practitioner | 831 Nw Council Dr, Suite 300, Gresham, OR 97030-3721 | 2007-07-26 |
| 1497954994 | Maryellen Hibbard | Nurse Practitioner | 831 Nw Council Dr, Suite 300, Gresham, OR 97030-3721 | 2007-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871819078 | Jamie Mieras | Podiatrist | 25050 Se Stark St, Ste 265, Gresham, OR 97030-3327 | 2010-04-13 |
| 1760463889 | Derek J Mccammon | Podiatrist | 24076 Se Stark St Ste 110, Gresham, OR 97030-3374 | 2005-11-07 |
| 1275730459 | Timothy James Mineo | Podiatrist | 24076 Se Stark St, Suite 110, Gresham, OR 97030-3373 | 2007-06-29 |
| 1891742318 | Gresham Podiatry Center, LLC | Podiatrist | 831 Nw Council Dr, Suite #203, Gresham, OR 97030-3721 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003432204 | Frontier Foot and Ankle Specialists LLC | Podiatrist | 780 2nd St Se # 10, Bandon, OR 97411-8354 | 2020-06-23 |
| 1710436662 | Hermiston Family Foot Clinic LLC | Podiatrist | 1050 W Elm Ave Ste 170, Hermiston, OR 97838-2715 | 2016-10-03 |
| 1255784492 | Sunny Sajjad | Podiatrist | 4905 River Rd N, Keizer, OR 97303-4539 | 2016-07-22 |
| 1285080556 | Sean Westover | Podiatrist | 1227 Ne 7th St Ste A, Grants Pass, OR 97526-1430 | 2016-05-05 |
| 1659774792 | Heather Keeler | Podiatrist | 1880 Willamette Falls Dr Ste 111, West Linn, OR 97068-4653 | 2014-10-03 |
| 1386051803 | Southwest Podiatry Center LLC | Podiatrist | 9370 Sw Greenburg Rd Ste 102, Portland, OR 97223-5428 | 2014-07-16 |
| 1578980694 | Amy Theppote | Podiatrist | 6542 Se Lake Rd Ste 102, Milwaukie, OR 97222-2245 | 2014-03-26 |
| 1144576224 | Trevor J Haynes | Podiatrist | 39400 Pioneer Blvd Ste 4, Sandy, OR 97055-8000 | 2012-07-26 |
| 1922379379 | John S Balknap Dpm PC | Podiatrist | 1716 E 12th St, The Dalles, OR 97058-3137 | 2012-01-17 |
| 1407145568 | Justin T Johnson Dpm Inc. | Podiatrist | 1661 Hwy 99 N Ste 201, Ashland, OR 97520-8900 | 2011-03-29 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. GRAYDEN WOODRUFF KING.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.