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General NPI Number Information
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NPI Number | 1477950699
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Entity Type | Individual
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Provider Name | BRITTANY GABOURY
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Gender | Female
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Dates
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Enumeration Date | 12/03/2014
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 11611 NE AINSWORTH CIR
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City | PORTLAND
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State | OR
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Zip | 97220-9017
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Country | US
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Telephone | 503-255-1841
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Fax |
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Provider Business Mailing Address
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Address Line | 3530 SE 136TH AVE
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City | PORTLAND
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State | OR
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Zip | 97236-2958
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 201709288LPN
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License Number State | OR
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