Provider Demographics
NPI:1992410013
Name:MEJIA-HERNANDEZ, GABRIELA LUCIA (CMA)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:LUCIA
Last Name:MEJIA-HERNANDEZ
Suffix:
Gender:F
Credentials:CMA
Other - Prefix:
Other - First Name:GABY
Other - Middle Name:LUCIA
Other - Last Name:MEJIA-HERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CMA
Mailing Address - Street 1:11835 SW WAGONWHEEL CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7324
Mailing Address - Country:US
Mailing Address - Phone:503-462-2941
Mailing Address - Fax:
Practice Address - Street 1:8915 SW CENTER ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6307
Practice Address - Country:US
Practice Address - Phone:503-726-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health