Provider Demographics
NPI:1235528282
Name:GUTMANN, DANIEL (QMHA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:GUTMANN
Suffix:
Gender:M
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SE 3RD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4036
Mailing Address - Country:US
Mailing Address - Phone:503-597-3970
Mailing Address - Fax:
Practice Address - Street 1:111 SE 3RD AVE STE B
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4036
Practice Address - Country:US
Practice Address - Phone:503-597-3970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health