Individual
AUDRIANNA JOY GURR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1722 NW RALEIGH ST SPC 408, MAILBOX 212, PORTLAND, OR 97209-1754
(503) 475-4005
Mailing address
1722 NW RALEIGH ST SPC 408, MAILBOX 212, PORTLAND, OR 97209-1754
(503) 475-4005
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C2599
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
09-06-17
OR
101YM0800X
Mental Health Counselor
C2599
OR
101YP2500X
Professional Counselor
C2599
OR
Other
Enumeration date
12/30/2009
Last updated
02/16/2011
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