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1053046722
PHILIP JOHN DEGRAFFENREID
PORTLAND, OR
NPI
1053046722
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OR 22-QMHP-R-1438)
Enumeration Date
2022-07-18
Last Update Date
2022-07-18
Business Address
PHILIP JOHN DEGRAFFENREID
33 NW BROADWAY
PORTLAND, OR 97209-3580
Phone number: 503-228-7134
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Mailing Address
PHILIP JOHN DEGRAFFENREID
232 NW 6TH AVE
PORTLAND, OR 97209-3609
Phone number: 503-294-1681
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