Individual
NICOLE MARIE GRANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, LMP
Contact information
Practice address
13712 NE 20TH AVE, VANCOUVER, WA 98686-2698
(360) 574-5944
Mailing address
9638 SW LARSON RD, GASTON, OR 97119-7721
(503) 998-0418
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
15945
OR
Other
Enumeration date
07/14/2009
Last updated
03/12/2013
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