Gena Dell Granberg, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Practice address

9775 SE Sunnyside Rd
Suite 200
Clackamas, OR 97015-5739

Phone

(503) 654-8417

Fax

(503) 654-8218

NPI assigned

May 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639384951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15914 NE 16TH CIR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986844130",
            "telephone_number": "360-944-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9775 SE SUNNYSIDE RD",
            "address_2": "SUITE 200",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155739",
            "telephone_number": "503-654-8417",
            "fax_number": "503-654-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANBERG",
        "first_name": "GENA",
        "middle_name": "DELL",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Ann Gould, LCSW
• Jaidyn Grable
• Abby Duval Grabowski, PT, DPT
• Margaret Graeber-Simon, MSW
• Maria Granados
• Daniel John Granville, DPM
• Lindsay C Gray
• Siobhan Heidi Gray, M.D.
• Bradi Grebien-Samkow
• Christa Green

• Family Nurse Practitioner in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.