Individual
GENNADY FORTUNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
880 82ND DR, GLADSTONE, OR 97027-1803
(503) 856-4798
Mailing address
12200 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97222-7281
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C6929
OR
Other
Enumeration date
04/25/2020
Last updated
10/02/2025
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