Individual
DR. DAVID GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, CR 115, PORTLAND, OR 97239-3011
(503) 494-1660
(503) 494-5407
Mailing address
3181 SW SAM JACKSON PARK RD, CR 115, PORTLAND, OR 97239-3011
(503) 494-1660
(503) 494-5407
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
C1066
OR
103TC1900X
Counseling Psychologist
Primary
C1066
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C1066
STATE OF OREGON BOARD OF LICENSED PROFESSIONAL COUNSELORS AND THERAPISTS
OR
Enumeration date
11/02/2012
Last updated
11/02/2012
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