Individual
JOY AUDREY GUMMOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1049 EDGEWATER ST NW, SALEM, OR 97304-4046
(503) 814-3343
Mailing address
PO BOX 3417, PORTLAND, OR 97208-3417
(503) 413-3900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10030186
OR
363LF0000X
Family Nurse Practitioner
Primary
10030186
OR
Other
Enumeration date
08/19/2024
Last updated
04/01/2026
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