Individual
CORY C GROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4925 N ALBINA AVE, PORTLAND, OR 97217-2609
(503) 548-4922
(503) 459-4495
Mailing address
4925 N ALBINA AVE, PORTLAND, OR 97217-2609
(503) 548-4922
(503) 459-4495
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/27/2009
Last updated
02/27/2009
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