Individual
DR. NATHANIEL WILLIAM GUMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
408 SW MONROE AVE STE M236, CORVALLIS, OR 97333-7210
(541) 250-0143
Mailing address
408 SW MONROE AVE STE M236, CORVALLIS, OR 97333-7210
(541) 250-0143
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
2738-57
WI
103TC1900X
Counseling Psychologist
Primary
2967
OR
Other
Enumeration date
09/15/2011
Last updated
10/23/2019
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