Individual
ANDREW PEGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17720 NE HALSEY ST STE A, PORTLAND, OR 97230-6771
(541) 505-8426
(541) 515-6938
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PROFESSIONALLICENSE
—
Other
Enumeration date
09/14/2018
Last updated
02/01/2023
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