Provider Demographics
NPI:1558249565
Name:WITT, GRACE RAMOS (MA)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:RAMOS
Last Name:WITT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-0002
Mailing Address - Country:US
Mailing Address - Phone:503-890-5255
Mailing Address - Fax:
Practice Address - Street 1:2920 SE BROOKWOOD AVE STE A
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-8553
Practice Address - Country:US
Practice Address - Phone:971-417-6054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health