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Individual

JOHN ROBERT GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
12360 E BURNSIDE ST, PORTLAND, OR 97233-1042
(971) 218-0508
Mailing address
214 COLLEGE DR NW UNIT 11, SALEM, OR 97304-4523
(971) 218-0508

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
01/11/2023
Last updated
01/11/2023
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