Individual
CHANDRA ELISE GERKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FSS
Contact information
Practice address
209 SW 4TH AVE STE 520, PORTLAND, OR 97204-1825
(503) 988-5464
Mailing address
133 SE 75TH AVE, PORTLAND, OR 97215-1453
(503) 358-5027
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
13863845543
OR
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
04/06/2023
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