Provider Demographics
NPI:1699575779
Name:GAERTNER, GABRIEL W (PMHNP)
Entity type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:W
Last Name:GAERTNER
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:GABE
Other - Middle Name:W
Other - Last Name:GAERTNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHNP
Mailing Address - Street 1:1162 WILLOW CREEK DR NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-2318
Mailing Address - Country:US
Mailing Address - Phone:503-207-3644
Mailing Address - Fax:
Practice Address - Street 1:1162 WILLOW CREEK DR NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-2318
Practice Address - Country:US
Practice Address - Phone:503-207-3644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10041871363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health