Travis A Gaters III
Counselor in Portland, OR. Individual provider (NPI-1).
NPI number1962050641
StatusActive
Last updated in NPPESAug 27, 2019
Details
- NPI
- 1962050641
- Entity type
- Individual (NPI-1)
- Name
- Travis A Gaters III
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 27, 2019
- Last updated
- Aug 27, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
7624 N Portsmouth AvePortland, OR 97203-5954
Phone 503-317-6762
Mailing address
7624 N Portsmouth AvePortland, OR 97203-5954
Phone 503-317-6762
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