Individual
GRANT SHARLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18765 SW BOONES FERRY RD, TUALATIN, OR 97062-8496
(503) 612-1000
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819
(503) 233-5405
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
10203626
OR
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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