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General NPI Number Information
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NPI Number | 1316964158
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Entity Type | Individual
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Provider Name | ANN GRUMMEL WARD ANP, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 04/09/2019
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Provider Practice Location Address
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Address Line | 758 NW POWHATAN TER
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City | PORTLAND
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State | OR
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Zip | 97210-2731
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Country | US
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Telephone | 503-894-9810
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Fax | 503-536-6719
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Provider Business Mailing Address
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Address Line | PO BOX 4049
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City | PORTLAND
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State | OR
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Zip | 97208-4049
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Country | US
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Telephone | 503-706-9791
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Fax | 503-536-6719
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 90007316N3
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 200450068NP
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License Number State | OR
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