Individual
WILLIAM G GRAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC I/QMHA
Contact information
Practice address
720 SE WASHINGTON ST, HILLSBORO, OR 97123-4230
(503) 648-0753
(503) 648-0755
Mailing address
855 S PALMETTO ST, CORNELIUS, OR 97113-6252
(503) 359-1495
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
99-11-15
OR
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500729451
—
OR
05
—
500729527
—
OR
Enumeration date
05/22/2015
Last updated
03/19/2018
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