Provider Demographics
NPI:1538633094
Name:GRADIN, JESSI (DC)
Entity type:Individual
Prefix:DR
First Name:JESSI
Middle Name:
Last Name:GRADIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JESSI
Other - Middle Name:
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:850 SW BOOTH BEND RD
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128
Mailing Address - Country:US
Mailing Address - Phone:503-472-2111
Mailing Address - Fax:503-434-5886
Practice Address - Street 1:850 SW BOOTH BEND RD
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128
Practice Address - Country:US
Practice Address - Phone:503-472-2111
Practice Address - Fax:503-434-5886
Is Sole Proprietor?:No
Enumeration Date:2019-01-17
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5968111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor