Individual
JEFF CLINTON GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT
Contact information
Practice address
235 S 3RD ST, SHELTON, WA 98584-2255
(360) 426-0890
Mailing address
1632 CYRENE DR NW, OLYMPIA, WA 98502-3008
(425) 583-8733
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60944500
WA
Other
Enumeration date
08/19/2019
Last updated
09/28/2023
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