Healthcare Provider Details

I. General information

NPI: 1932013364
Provider Name (Legal Business Name): GABRIELLA ISABEL ROSALES MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10420 NE WASCO ST
PORTLAND OR
97220-3928
US

IV. Provider business mailing address

2350 SE 50TH AVE APT 25
PORTLAND OR
97215-3800
US

V. Phone/Fax

Practice location:
  • Phone: 503-688-2784
  • Fax:
Mailing address:
  • Phone: 503-688-2784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: