Healthcare Provider Details

I. General information

NPI: 1952860066
Provider Name (Legal Business Name): MCARTHUR, GRUFF & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 SE WASHINGTON ST
HILLSBORO OR
97123-4142
US

IV. Provider business mailing address

1846 E INNOVATION PARK DR
ORO VALLEY AZ
85755-1963
US

V. Phone/Fax

Practice location:
  • Phone: 503-755-6703
  • Fax: 503-755-6704
Mailing address:
  • Phone: 503-755-6703
  • Fax: 503-755-6704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CARMEN KOSICEK
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 503-755-6703