Healthcare Provider Details

I. General information

NPI: 1154566719
Provider Name (Legal Business Name): ABBEY L GAMACHE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2008
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 DRAGON DR
MONROE OR
97456-9604
US

IV. Provider business mailing address

PO BOX 579
CORVALLIS OR
97339-0579
US

V. Phone/Fax

Practice location:
  • Phone: 541-766-6000
  • Fax: 541-766-6047
Mailing address:
  • Phone: 541-766-6835
  • Fax: 541-766-6186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL6501
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: