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General NPI Number Information
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NPI Number | 1487883955
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Entity Type | Individual
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Provider Name | LINDA M GOSSLING PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 10011 SE DIVISION ST SUITE 307
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City | PORTLAND
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State | OR
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Zip | 97266-1351
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Country | US
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Telephone | 503-467-7690
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Fax | 503-548-0315
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Provider Business Mailing Address
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Address Line | 10011 SE DIVISION ST SUITE 307
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City | PORTLAND
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State | OR
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Zip | 97266-1351
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Country | US
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Telephone | 503-467-7690
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Fax | 503-548-0315
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 200950084NP
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License Number State | OR
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