Provider Demographics
NPI:1316187826
Name:SMILEY, GAIL R (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:R
Last Name:SMILEY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7912 SW 35TH AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-2427
Mailing Address - Country:US
Mailing Address - Phone:503-245-0088
Mailing Address - Fax:503-638-9953
Practice Address - Street 1:7912 SW 35TH AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2427
Practice Address - Country:US
Practice Address - Phone:503-245-0088
Practice Address - Fax:503-638-9953
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR677101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health