Individual
BRIONNA GUNDLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
314 NE 19TH AVE, PORTLAND, OR 97232-2829
(503) 239-8181
Mailing address
4621 S CORBETT AVE, PORTLAND, OR 97239-4209
(503) 619-6754
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10031578
OR
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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