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Individual

DR. PETER ARDEN GROVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
10330 SE 32ND AVE, SUITE 205, MILWAUKIE, OR 97222-6587
(503) 513-8950
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1163
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500619622
OR
01
P01046663
RR MEDICARE
OR
Enumeration date
10/17/2006
Last updated
10/31/2012
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