Individual
MS. STEPHANIE JANE GROSUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3320 SE HOLGATE BLVD, PORTLAND, OR 97202-3459
(503) 231-1411
Mailing address
7224 SE 18TH AVE, PORTLAND, OR 97202-5835
(503) 954-3239
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1030351
OR
Other
Enumeration date
02/12/2010
Last updated
02/12/2010
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