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NPI Code Detail

MEDICARE: WENDY GOURLEY

MEDICARE: WENDY GOURLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1750217766
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY GOURLEY
Provider Business Mailing Address
First Line : 119 PENN ST APT 23
Second Line :
City : PORT ANGELES
State : WA
Zip : 98362-4640
Country : US
Telephone Number : 564-215-9659
Fax Number :
Provider Business Practice Location Address
First Line : 716 S CHASE ST
Second Line :
City : PORT ANGELES
State : WA
Zip : 98362-6122
Country : US
Telephone Number : 360-203-6997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2026
Last Update Date : 06/18/2026

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Directions to “ WENDY GOURLEY ” Practice Location

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