Provider Demographics
NPI:1316116395
Name:GRISWOLD, LINDA KAREN (LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:KAREN
Last Name:GRISWOLD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 KRUSE WAY STE 114
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3599
Mailing Address - Country:US
Mailing Address - Phone:503-744-3244
Mailing Address - Fax:503-650-2786
Practice Address - Street 1:4500 KRUSE WAY STE 114
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3599
Practice Address - Country:US
Practice Address - Phone:503-744-3244
Practice Address - Fax:503-650-2786
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2088101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional