NPI 1134482904

Grant Ian Peterson

Practitioner Adult Companion Oregon City, OR

Practice location

Address: 304 Pearl St, Oregon City, OR 97045-2684
Phone: (503) 238-0769
Mailing address: PO Box 8459, Portland, OR 97207-8459

Registered specialties

Adult Companion Primary

Nursing Service Related Providers Taxonomy 372600000X

Other Adult Companion providers in Oregon →

Registry record

NPI: 1134482904
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Jun 2012
Record last updated: 18 Jun 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.