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Individual

ANN GRUMMEL WARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ANP, PMHNP

Contact information

Practice address
758 NW POWHATAN TER, PORTLAND, OR 97210-2731
(503) 894-9810
(503) 536-6719
Mailing address
PO BOX 4049, PORTLAND, OR 97208-4049
(503) 706-9791
(503) 536-6719

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
90007316N3
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
200450068NP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
054123026
BLUE CROSS
Enumeration date
07/17/2006
Last updated
04/09/2019
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