Individual
TYREL ALAN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4550 CARMAN DR, LAKE OSWEGO, OR 97035-2520
(503) 675-6055
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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