Individual
LINDA MARIE GAETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP, PMHNP,MN, BC
Contact information
Practice address
5331 SW MACADAM AVE, SUITE 358, PORTLAND, OR 97239-6104
(503) 244-0655
(503) 242-0492
Mailing address
5331 SW MACADAM, SUITE 358, PORTLAND, OR 97239-3011
(503) 244-0655
(503) 242-0492
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0000366690N3
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0000366690N6
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
068239
—
OR
Enumeration date
02/05/2007
Last updated
03/03/2009
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