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Mr. Grant Judson Gill
Mental Health Counselor in North Bend, Oregon
NPI 1427667328

Grant Judson Gill is a Mental Health Counselor based in Coos Bay, OR and is specialized in Mental Health. Grant Judson Gill practices in North Bend, OR. The NPI Number for Grant Judson Gill is 1427667328 and holds a License No. (Oregon).

The current practice location address for Grant Judson Gill is 1817 16Th St, North Bend, OR and can be reached out via phone at 541-297-6230.

Location: 1817 16Th St, North Bend, OR, 97420-2988
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1427667328
Provider Name
Grant Judson Gill
Credential
Provider Entity Type
Individual
Gender
Male
Address
1817 16Th St, North Bend, OR, 97420-2988
Phone Number
541-297-6230
Fax Number
Provider Enumeration Date
07/27/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CMK7119B 05 OR
institution
Provider Business Practice Location Address Details
Address
1817 16Th St
City
North Bend
State
Oregon
Zip
97459-2629
Phone Number
541-297-6230
Fax Number
person
Provider Business Mailing Address Details
Address
1817 16Th St
City
North Bend
State
Oregon
Zip
97459-2629
Phone Number
541-297-6230
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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