Individual
JOSEPH PATRICK GORHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
12360 E BURNSIDE ST, PORTLAND, OR 97233-1042
(971) 279-4800
(971) 279-2051
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
202212803RN
OR
163W00000X
Registered Nurse
RN61413352
WA
363L00000X
Nurse Practitioner
Primary
202214982NP-PP
OR
363LF0000X
Family Nurse Practitioner
AP61415360
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2220098
—
WA
05
—
500811571
—
OR
Enumeration date
09/29/2022
Last updated
03/18/2025
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