Individual provider · Type 1 NPI

Casey Grad Granbois

Psychiatric/Mental Health Nurse Practitioner · Portland, OR

NPI number 1154882132 Active

Practice location

812 SW Washington St
Portland, OR 97205-3222

Mailing address

3225 SE 69th Ave
Portland, OR 97206-1948

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X202100056 (OR)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1154882132

Casey Grad Granbois's National Provider Identifier is 1154882132, issued on Mar 30, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Portland, OR. The record was last updated on Apr 19, 2021.