person
Ryan Glen Grissom
Mental Health Counselor in Portland, Oregon
NPI 1730898404

Ryan Glen Grissom is a Mental Health Counselor based in Medford, OR and is specialized in Mental Health. Ryan Glen Grissom practices in Portland, OR. The NPI Number for Ryan Glen Grissom is 1730898404 and holds a License No. (Oregon).

The current practice location address for Ryan Glen Grissom is 12511 Se Raymond St, Portland, OR and can be reached out via phone at 503-761-2580 and via fax at 503-761-2548.

Location: 12511 Se Raymond St, Portland, OR, 97504-4004
person
Provider Profile Details
NPI Number
1730898404
Provider Name
Ryan Glen Grissom
Credential
Provider Entity Type
Individual
Gender
Male
Address
12511 Se Raymond St, Portland, OR, 97504-4004
Phone Number
503-761-2580
Fax Number
503-761-2548
Provider Enumeration Date
11/21/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
12511 Se Raymond St
City
State
Zip
97236-3931
Phone Number
503-761-2580
Fax Number
503-761-2548
person
Provider Business Mailing Address Details
Address
12511 Se Raymond St
City
State
Zip
97236-3931
Phone Number
503-761-2580
Fax Number
503-761-2548
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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