Individual
MRS. AMY GROULX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5506 SE MITCHELL ST, PORTLAND, OR 97206
(503) 774-9512
Mailing address
5506 SE MITCHELL ST, PORTLAND, OR 97206-4844
(503) 774-9512
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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