Provider Demographics
NPI:1528307832
Name:GILMER, LAURIE A (QMHP)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:GILMER
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11211 SE 82ND AVE
Mailing Address - Street 2:SUITE O
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-7624
Mailing Address - Country:US
Mailing Address - Phone:503-722-6200
Mailing Address - Fax:503-722-6545
Practice Address - Street 1:2051 KAEN RD
Practice Address - Street 2:SUITE 367
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4035
Practice Address - Country:US
Practice Address - Phone:503-742-5300
Practice Address - Fax:503-742-5979
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health