Individual
ELONA KASSIA DELLABOUGH-GORMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
727 W BURNSIDE ST, PORTLAND, OR 97209-3514
(503) 228-4533
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201600281RN
OR
363LF0000X
Family Nurse Practitioner
Primary
10016533
OR
Other
Enumeration date
05/29/2019
Last updated
12/16/2024
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