Individual
DEIDRA GRAVINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6926 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-7254
(360) 993-3000
Mailing address
PO BOX 1337, VANCOUVER, WA 98666-1337
(360) 993-3000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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