Individual
MARY GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1312 SW WASHINGTON STREET, PORTLAND, OR 97208-3007
(503) 535-1150
Mailing address
PO BOX 3007, PORTLAND, OR 97208-3007
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/10/2011
Last updated
05/10/2012
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