Organization
THERESA J PAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALINA GRIMSTED (BILLING/CREDENTIALING)
(503) 755-8988
Entity
Organization
Contact information
Practice address
3419 NE SANDY BLVD, PORTLAND, OR 97232-1959
(503) 282-6267
Mailing address
3419 NE SANDY BLVD, PORTLAND, OR 97232-1959
(503) 282-6267
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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