Individual
IRISA MARIE GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
2519 21ST AVE, FOREST GROVE, OR 97116-1738
(908) 868-3883
Mailing address
84 CENTENNIAL LOOP, EUGENE, OR 97401-7909
(541) 255-2681
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
446714
OR
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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