CASEY GRAD GRANBOIS

PORTLAND, OR
NPI1154882132
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: OR  202100056)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2019-03-30
Last Update Date2021-04-19
Business Address
CASEY GRAD GRANBOIS
812 SW WASHINGTON ST
PORTLAND, OR 97205-3222
Phone number: 503-622-8964
Mailing Address
CASEY GRAD GRANBOIS
3225 SE 69TH AVE
PORTLAND, OR 97206-1948
Phone number: 503-421-0235