Provider Demographics
NPI:1023156338
Name:HOWARD, GLADYS M (BA)
Entity type:Individual
Prefix:MS
First Name:GLADYS
Middle Name:M
Last Name:HOWARD
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 1:56 NE EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-2652
Mailing Address - Country:US
Mailing Address - Phone:503-287-2510
Mailing Address - Fax:
Practice Address - Street 1:3034 NE M L KING BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-3053
Practice Address - Country:US
Practice Address - Phone:503-889-2853
Practice Address - Fax:503-735-0912
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator