Individual ProviderMary Grace PorterFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address506 4th St., Grande Ronde Hospital Regional Medical Clinic, La Grande, OR 97850(541) 663-3138PECOS EnrollmentBased on the most recent information from CMS, provider Mary Grace Porter does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1477739720Provider TypeIndividualFull NamePorter, Mary GraceTitleDr.CredentialD.OGenderFemaleSole ProprietorNoEnumeration Date1/17/2008Last Updated6/22/2021Contact InformationPractice LocationPractice Address506 4th St., Grande Ronde Hospital Regional Medical Clinic, La Grande, OR 97850Phone(541) 663-3138Fax(541) 975-5120Mailing LocationMailing Address506 4th St., La Grande, OR 97850Phone(541) 663-3138Fax(541) 975-5120Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseDO28026OregonProvider IdentifiersIDDescriptionIssuerID218112DescriptionMedicaidIssuerUnlistedOregon