Healthcare Provider Details

I. General information

NPI: 1790059624
Provider Name (Legal Business Name): ABIGAIL MARIE BROWN LPC, CADCII, QMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABIGAIL MARIE GUNNELL MA, CADCI, QMHP

II. Dates (important events)

Enumeration Date: 02/23/2012
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10315 NE TANASBOURNE DR
HILLSBORO OR
97124-7836
US

IV. Provider business mailing address

500 NE MULTNOMAH ST STE 100
PORTLAND OR
97232-2031
US

V. Phone/Fax

Practice location:
  • Phone: 800-813-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number16-06-18
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC3656
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: