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1194203869
JORDAN ALYSSA GRANT
PORTLAND, OR
NPI
1194203869
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2018-08-03
Last Update Date
2021-06-02
Business Address
JORDAN ALYSSA GRANT
3415 SE POWELL BLVD
PORTLAND, OR 97202-3371
Phone number: 503-234-9591
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Mailing Address
JORDAN ALYSSA GRANT
3415 SE POWELL BLVD
PORTLAND, OR 97202-3371
Phone number: 503-234-9591
Copy
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