Individual
TERRY GAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
948 NE 102ND AVE STE 101, PORTLAND, OR 97220-4064
(503) 257-0381
Mailing address
948 NE 102ND AVE STE 101, PORTLAND, OR 97220-4064
(503) 257-0381
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
15-CRM-027
OR
Other
Enumeration date
03/16/2017
Last updated
03/16/2017
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