Individual
STEPHANI G GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3966 SE GLADSTONE ST, PORTLAND, OR 97202-3138
(503) 816-9606
Mailing address
3966 SE GLADSTONE ST, PORTLAND, OR 97202-3138
(503) 816-9606
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
C3256
OR
Other
Enumeration date
12/30/2014
Last updated
05/15/2024
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