Individual
CAROL JEAN GRAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC1
Contact information
Practice address
3945 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5241
(503) 839-9462
Mailing address
3945 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5241
(503) 839-9462
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12-03-23
OR
Other
Enumeration date
05/01/2014
Last updated
05/01/2014
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