Individual
DR. JENNIFER GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, PMHNP, RN, LMT
Contact information
Practice address
2110 MISSION ST SE STE 305, SALEM, OR 97302-0038
(503) 379-1902
Mailing address
5301 SW TAYLORS FERRY RD, PORTLAND, OR 97219-5879
(503) 313-8888
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
202009213RN
OR
225700000X
Massage Therapist
19165
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
TBD
OR
Other
Enumeration date
06/20/2013
Last updated
07/13/2023
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