Provider Demographics
NPI:1134906910
Name:KOHNE, GABRIELLE ZOE (PSS, CRM)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ZOE
Last Name:KOHNE
Suffix:
Gender:F
Credentials:PSS, CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 COBURG RD STE C
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6114
Mailing Address - Country:US
Mailing Address - Phone:541-505-9190
Mailing Address - Fax:
Practice Address - Street 1:315 COBURG RD STE C
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6114
Practice Address - Country:US
Practice Address - Phone:541-505-9190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23-CRM-2294175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist