Provider Demographics
NPI:1013154053
Name:GILLMOR, ONYRIA (ND, CPM)
Entity Type:Individual
Prefix:MRS
First Name:ONYRIA
Middle Name:
Last Name:GILLMOR
Suffix:
Gender:F
Credentials:ND, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 SE 37TH AVE APT 209
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-5898
Mailing Address - Country:US
Mailing Address - Phone:520-409-2851
Mailing Address - Fax:480-595-0781
Practice Address - Street 1:19365 SW 65TH AVE STE 209
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9196
Practice Address - Country:US
Practice Address - Phone:503-855-4341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLM149176B00000X
OR13010006176B00000X
OR2030175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No176B00000XOther Service ProvidersMidwife