Provider Demographics
NPI:1942952247
Name:GRITZ, MELISSA (MSED)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:GRITZ
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72694 BLAKELY ST
Mailing Address - Street 2:
Mailing Address - City:RAINIER
Mailing Address - State:OR
Mailing Address - Zip Code:97048-3801
Mailing Address - Country:US
Mailing Address - Phone:503-970-7901
Mailing Address - Fax:
Practice Address - Street 1:72694 BLAKELY ST
Practice Address - Street 2:
Practice Address - City:RAINIER
Practice Address - State:OR
Practice Address - Zip Code:97048-3801
Practice Address - Country:US
Practice Address - Phone:503-970-7901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical