Individual
FIONA KRISTINA GORNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1825 N WILLIAMS AVE, PORTLAND, OR 97227-1864
(503) 288-2615
(503) 288-0339
Mailing address
1825 N WILLIAMS, PORTLAND, OR 97227
(503) 288-2615
(503) 288-0339
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6914
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237206
—
OR
Enumeration date
10/22/2012
Last updated
10/22/2012
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