Individual
MR. MICHAEL DAVID GRACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 434-7523
(503) 434-9846
Mailing address
5415 SW WESTGATE DR, PORTLAND, OR 97221-2409
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OR
101YM0800X
Mental Health Counselor
—
OR
171M00000X
Case Manager/Care Coordinator
—
OR
Other
Enumeration date
12/02/2021
Last updated
06/23/2022
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