Individual provider · Type 1 NPI

Philip John Degraffenreid

Mental Health Counselor · Portland, OR

NPI number 1053046722 Active

Practice location

33 NW Broadway
Portland, OR 97209-3580

Call (503) 228-7134 Map

Fax (503) 501-5679

Mailing address

232 NW 6th Ave
Portland, OR 97209-3609

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X22-QMHP-R-1438 (OR)

Mental Health Counselor: Definition to come...

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About NPI 1053046722

Philip John Degraffenreid's National Provider Identifier is 1053046722, issued on Jul 18, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Jul 18, 2022.