Grant Ian Peterson
NPI #1134482904 in Oregon City, Oregon
Provider Information
- NPI Number
- 1134482904
- Entity Type
- Individual
- Name
- Grant Ian Peterson
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Adult Companion
- Enumeration Date
- Jun 18, 2012
- Last Updated
- Jun 18, 2012
Practice Location
- Address
- 304 PEARL ST
- City
- Oregon City
- State
- Oregon
- ZIP Code
- 97045-2684
- Phone
- (503) 238-0769
Specialties & Taxonomy Codes
| Specialty |
|---|
| Adult Companion |
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