Individual
ANTHONY DALE GASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
9155 SW BARNES RD STE 333, PORTLAND, OR 97225-6630
(503) 216-5102
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
17997
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201508082NP-PP
OR
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
1214
CA
Other
Enumeration date
08/13/2010
Last updated
03/09/2021
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