Individual
WESLEY GROUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5200 SW MACADAM AVE, SUITE 100, PORTLAND, OR 97239-6103
(503) 224-1998
Mailing address
5200 SW MACADAM AVE, SUITE 100, PORTLAND, OR 97239-6103
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
298029
OR
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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