| Polly Gravely Counseling Llc | |
|
5319 Sw Westgate Dr Ste 246 Portland OR 97221-2434 | |
| (503) 310-7472 | |
| Not Available |
| Full Name | Polly Gravely Counseling Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 5319 Sw Westgate Dr Ste 246, Portland, Oregon |
| Authorized Official Name and Position | Polly Gravely (PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 5033107472 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Polly Gravely Counseling Llc 4028 Sw 53rd Pl Portland OR 97221-2015 Ph: (503) 310-7472 | Polly Gravely Counseling Llc 5319 Sw Westgate Dr Ste 246 Portland OR 97221-2434 Ph: (503) 310-7472 |
| NPI Number | 1588297063 |
|---|---|
| Provider Enumeration Date | 02/12/2020 |
| Last Update Date | 06/08/2021 |
| Certification Date | 06/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588297063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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