Individual
PETER GORDON GOURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1111 W IRONWOOD DR STE B, COEUR D ALENE, ID 83814-2604
(208) 664-1594
(208) 664-5867
Mailing address
2481 HALLEBERRY, HAYDEN, ID 83835-8339
(509) 989-7764
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30005913
WA
Other
Enumeration date
06/16/2006
Last updated
01/06/2025
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