Individual
GRACE SPRING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32 NE 11TH AVE, PORTLAND, OR 97232-3001
(503) 542-7635
Mailing address
3533 NE GRAND AVE, PORTLAND, OR 97212-2102
(610) 764-3142
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/20/2021
Last updated
07/20/2021
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