Individual
ALEXIS GRADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3955 SALMON RIVER HWY, OTIS, OR 97368-9778
(541) 614-4437
(888) 977-2106
Mailing address
3955 SALMON RIVER HWY, OTIS, OR 97368-9778
(541) 614-4437
(888) 977-2106
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
T-22-1690
OR
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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