Provider Demographics
NPI:1265012884
Name:LUTHER, GABRIELLA M (BA)
Entity Type:Individual
Prefix:MS
First Name:GABRIELLA
Middle Name:M
Last Name:LUTHER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 MCMILLAN ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3221
Mailing Address - Country:US
Mailing Address - Phone:503-310-2874
Mailing Address - Fax:
Practice Address - Street 1:3620 SE POWELL BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1880
Practice Address - Country:US
Practice Address - Phone:503-486-8936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health