Individual
THAOANH KAT GAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8041 E BURNSIDE ST, PORTLAND, OR 97215-1548
(503) 239-8400
(503) 239-8407
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
(503) 239-8407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
106S00000X
Behavior Technician
Primary
—
OR
Other
Enumeration date
09/13/2018
Last updated
03/31/2020
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