Individual provider · Type 1 NPI

Jason Ryan Grismore, CADC I CANDIDATE

Addiction (Substance Use Disorder) Counselor · Tigard, OR

NPI number 1215329545 Active

Practice location

10362 SW Mcdonald
Tigard, OR 97224

Call (503) 624-0312 Map

Fax (503) 639-3973

Mailing address

1027 E. Burnside St.
Portland, OR 97214

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1215329545

Jason Ryan Grismore, CADC I CANDIDATE's National Provider Identifier is 1215329545, issued on Feb 24, 2015. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Tigard, OR. The record was last updated on Feb 24, 2015.