Individual
MS. KATHLEEN SUSANNE GAMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
THW, PSS
Contact information
Practice address
280 NE SANTIAM BLVD, MILL CITY, OR 97360
(971) 332-5676
Mailing address
PO BOX 875, MILL CITY, OR 97360-0875
(971) 388-8841
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
105011
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105011
OREGON HEALTH ASSOCIATION
OR
Enumeration date
07/20/2021
Last updated
07/20/2021
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