Individual
AUTUMN GRUBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18980 LELAND RD, OREGON CITY, OR 97045-8511
(503) 650-8605
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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