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1720631609
GRANT WILLIAM CUNNINGHAM
GLADSTONE, OR
NPI
1720631609
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 19-R-14)
Enumeration Date
2019-07-19
Last Update Date
2019-07-19
Business Address
GRANT WILLIAM CUNNINGHAM
880 82ND DR
GLADSTONE, OR 97027-1803
Phone number: 503-659-5515
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Mailing Address
GRANT WILLIAM CUNNINGHAM
22550 SW HIGHLAND DR APT 340
SHERWOOD, OR 97140-7041
Phone number: 720-988-9565
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