Individual
JESSICA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-2000
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
013644
OR
235Z00000X
Speech-Language Pathologist
Primary
13644
OR
Other
Enumeration date
06/15/2012
Last updated
05/12/2020
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