Healthcare Provider Details

I. General information

NPI: 1306649553
Provider Name (Legal Business Name): GABRIELA FREIRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 NE GLISAN ST STE 11N-1
PORTLAND OR
97213-2933
US

IV. Provider business mailing address

3136 NE COUCH ST
PORTLAND OR
97232-3374
US

V. Phone/Fax

Practice location:
  • Phone: 808-430-0015
  • Fax:
Mailing address:
  • Phone: 808-430-0015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number10010046
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: