Provider Demographics
NPI:1366292716
Name:CHRISTENSEN GRIMSHAW, VICTORIA L (MA, MSW)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:CHRISTENSEN GRIMSHAW
Suffix:
Gender:F
Credentials:MA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2503
Mailing Address - Country:US
Mailing Address - Phone:928-699-7397
Mailing Address - Fax:
Practice Address - Street 1:201 W MAIN ST STE 4B
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-2734
Practice Address - Country:US
Practice Address - Phone:541-622-3039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical