Individual
KRYSTAL ELIZABETH GRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 NE DIVISION ST STE 100, GRESHAM, OR 97030-4617
(503) 666-3808
Mailing address
4119 SW 18TH CT, GRESHAM, OR 97080-8344
(503) 891-3696
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/08/2022
Last updated
12/08/2022
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