Provider Demographics
NPI:1144014275
Name:GRACE INTEGRATED HEALTHCARE LLC
Entity type:Organization
Organization Name:GRACE INTEGRATED HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-668-4504
Mailing Address - Street 1:120 SHELTON MCMURPHEY BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8718
Mailing Address - Country:US
Mailing Address - Phone:215-668-4504
Mailing Address - Fax:
Practice Address - Street 1:120 SHELTON MCMURPHEY BLVD STE 300
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8718
Practice Address - Country:US
Practice Address - Phone:215-668-4504
Practice Address - Fax:541-364-6638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center