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Organization

ACTIVE RECOVERY TMS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID GRANO (CEO)
(503) 708-9901
Entity
Organization

Contact information

Practice address
4949 MEADOWS RD STE 250, LAKE OSWEGO, OR 97035-3147
(503) 708-9901
Mailing address
4949 MEADOWS RD STE 250, LAKE OSWEGO, OR 97035-3147
(503) 708-9901

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2084P0800X
COMMERCIAL INSURANCE
OR
05
2084P0800X
OR
Enumeration date
11/20/2020
Last updated
11/20/2020
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