Gandarilla, Omar

Gandarilla, Omar is an individual health care provider with primary practice located at 17214 Se Division St , Portland OR 97236-1282. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as his primary health care specialty. Gandarilla, Omar can be contacted via phone (503) 761-5272.

Contact Information

Primary practice address
17214 Se Division St Portland OR 97236-1282
Phone: (503) 761-5272
Fax: (503) 762-6250
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X

Profile Details

NPI number 1427455534
LBN Legal business name Gandarilla, Omar
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2014
Last updated Dec 4th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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