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1215329545
JASON RYAN GRISMORE
TIGARD, OR
NPI
1215329545
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-02-24
Last Update Date
2015-02-24
Business Address
Mr. JASON RYAN GRISMORE CADC I Candidate
10362 SW MCDONALD
TIGARD, OR 97224
Phone number: 503-624-0312
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Mailing Address
Mr. JASON RYAN GRISMORE CADC I Candidate
1027 E. BURNSIDE ST.
PORTLAND, OR 97214
Phone number: 503-239-8400
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