Provider Demographics
NPI:1750401121
Name:GOURLEY, ANNE L (BS)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:L
Last Name:GOURLEY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MRS
Other - First Name:ANNE
Other - Middle Name:L
Other - Last Name:HEUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321
Mailing Address - Country:US
Mailing Address - Phone:541-967-3866
Mailing Address - Fax:541-812-8812
Practice Address - Street 1:445 S.W 3RD AVE.
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2272
Practice Address - Country:US
Practice Address - Phone:541-967-3866
Practice Address - Fax:541-812-8812
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator