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1205337516
KEVIN GRAY
TIGARD, OR
NPI
1205337516
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 201400138LPN)
Enumeration Date
2018-02-22
Last Update Date
2019-11-07
Business Address
KEVIN GRAY LPN
10763 SW GREENBURG RD
TIGARD, OR 97223-5492
Phone number: 503-684-8159
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Mailing Address
KEVIN GRAY LPN
6601 NE 78TH CT STE A3
PORTLAND, OR 97218-2823
Phone number: 503-917-3617
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