Individual
GRACIE JAMES DILLEY-BUCCIARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4036 NE SANDY BLVD STE 203, PORTLAND, OR 97212-5335
(503) 953-0957
Mailing address
4036 NE SANDY BLVD STE 3, PORTLAND, OR 97212-5335
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
T2430
OR
Other
Enumeration date
09/11/2019
Last updated
12/06/2023
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