| Michaela Grillo Llc | |
|
942 Windemere Dr Nw Salem OR 97304 | |
| (503) 482-9089 | |
| (971) 339-7115 |
| Full Name | Michaela Grillo Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 942 Windemere Dr Nw, Salem, Oregon |
| Authorized Official Name and Position | Michaela Grillo (OWNER) |
| Authorized Official Contact | 9787907466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michaela Grillo Llc 3055 Nw Yeon Ave # 866 Portland OR 97210-1519 Ph: (503) 482-9089 | Michaela Grillo Llc 942 Windemere Dr Nw Salem OR 97304 Ph: (503) 482-9089 |
| NPI Number | 1164133427 |
|---|---|
| Provider Enumeration Date | 12/07/2022 |
| Last Update Date | 12/07/2022 |
| Certification Date | 12/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164133427 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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