Provider Demographics
NPI:1558979906
Name:GASSMAN, JANET LEE
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEE
Last Name:GASSMAN
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 1:13550 SE 215TH CT
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:OR
Mailing Address - Zip Code:97089-7220
Mailing Address - Country:US
Mailing Address - Phone:503-658-6639
Mailing Address - Fax:
Practice Address - Street 1:13550 SE 215TH CT
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:OR
Practice Address - Zip Code:97089-7220
Practice Address - Country:US
Practice Address - Phone:503-658-6639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health