Individual
MR. STEPHEN THOMAS GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2705 E BURNSIDE ST STE 102, PORTLAND, OR 97214-1767
(503) 752-9943
(503) 230-1012
Mailing address
2705 E BURNSIDE ST STE 102, PORTLAND, OR 97214-1767
(503) 752-9943
(503) 230-1012
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
L3820
OR
1041C0700X
Clinical Social Worker
Primary
L3820
OR
Other
Enumeration date
11/06/2007
Last updated
11/06/2007
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