Michael David Gracon

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

627 NE Evans St
McMinnville, OR 97128-3923

Phone

(503) 434-7523

Fax

(503) 434-9846

NPI assigned

Dec 2, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1912665357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 SW WESTGATE DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212409",
            "telephone_number": "503-645-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 NE EVANS ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971283923",
            "telephone_number": "503-434-7523",
            "fax_number": "503-434-9846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5415 SW Westgate Dr",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972212409",
            "country_code": "US",
            "telephone_number": "503-645-3581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACON",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-02",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Good, CMA, QMHA
• Melissa Claire Goodman
• Ellen M Goss
• Bethany Gould, LCSW
• Alexis Govert
• Jessi Gradin, D.C
• Tonya Ashley Graftenreed
• Colin Stuart Graser, DMD
• Marisa Paige Grate
• Georgia Graven

• Counselor in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.