Individual
TELIA NICOLE ANDERSON-GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NON CREDENTIAL
Contact information
Practice address
12600 SE STARK ST, PORTLAND, OR 97233-1058
(503) 477-8208
Mailing address
847 NE WEBSTER ST, PORTLAND, OR 97211-3848
(503) 998-3946
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
OR
374J00000X
Doula
Primary
—
OR
Other
Enumeration date
02/05/2007
Last updated
07/12/2023
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