Provider Demographics
NPI:1982297974
Name:GALE, NORMAN TODD (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:TODD
Last Name:GALE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1315
Mailing Address - Street 2:
Mailing Address - City:DEPOE BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97341-1315
Mailing Address - Country:US
Mailing Address - Phone:541-819-5678
Mailing Address - Fax:541-819-5681
Practice Address - Street 1:644 SW COAST HWY STE 202
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-5064
Practice Address - Country:US
Practice Address - Phone:541-819-5678
Practice Address - Fax:541-819-5681
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202101554NP-PP2084P0800X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry