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1871113415
SUNYA GRANTHAM
LAKE OSWEGO, OR
NPI
1871113415
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OR R5983)
Enumeration Date
2020-04-23
Last Update Date
2020-04-23
Business Address
SUNYA GRANTHAM LFMT-Intern
14511 WESTLAKE DR
LAKE OSWEGO, OR 97035-7783
Phone number: 503-638-1603
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Mailing Address
SUNYA GRANTHAM LFMT-Intern
22185 SW STAFFORD RD
TUALATIN, OR 97062-8727
Phone number: 503-638-1603
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