Provider Demographics
NPI:1467028878
Name:GONZALEZ, DORIS
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NE 8TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-7318
Mailing Address - Country:US
Mailing Address - Phone:971-888-2425
Mailing Address - Fax:
Practice Address - Street 1:600 NE 8TH ST STE 300
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7318
Practice Address - Country:US
Practice Address - Phone:971-888-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker