Individual
MR. JASON RYAN GRISMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC I CANDIDATE
Contact information
Practice address
10362 SW MCDONALD, TIGARD, OR 97224
(503) 624-0312
(503) 639-3973
Mailing address
1027 E. BURNSIDE ST., PORTLAND, OR 97214
(503) 239-8400
(503) 269-8407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/24/2015
Last updated
02/24/2015
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