Individual
NATASHA MARIE AVALON GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP, DNP
Contact information
Practice address
619 NW 6TH AVE FL 3, PORTLAND, OR 97209-3964
(503) 988-5090
(503) 988-5022
Mailing address
619 NW 6TH AVE FL 3, PORTLAND, OR 97209-3964
(503) 988-5090
(503) 988-5022
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10001791
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/09/2021
Last updated
05/15/2024
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