TIMOTHY GAZDZIAK (NPI# 1083814677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083814677 |
| Entity Type | Individual |
| Full Name | TIMOTHY GAZDZIAK |
| Credential | LPC |
| Practice Address |
1700 Nw Civic Dr Suite 310 Gresham OR 97030-3770 |
| Practice Telephone | 5036668832 |
| Practice Fax Number | 5036698641 |
| Mailing Telephone | 5036668832 |
| Mailing Fax Number | 5036698641 |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2013-03-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | C2938 | OR | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
C2938 | OR | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
C2938 | OR | Behavioral Health & Social Service Providers |
| Street Address |
1700 NW CIVIC DR SUITE 310 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-3770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447336037 | Kerry E M Phifer | Nurse Practitioner | 1700 Nw Civic Dr, Suite 301, Gresham, OR 97030-3770 | 2006-10-27 |
| 1407251408 | Nicklaus Clark | Counselor | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2014-11-03 |
| 1346645777 | Patricia Bootzin | Counselor | 1700 Nw Civic Dr, Sutie 310, Gresham, OR 97030-3770 | 2014-10-28 |
| 1255741773 | Sarah Dangaran | Behavioral Analyst | 1700 Nw Civic Dr, 310, Gresham, OR 97030-3770 | 2014-05-06 |
| 1063761716 | Clark Paul Rector | Psychologist | 1700 Nw Civic Dr, Gresham, OR 97030-3770 | 2012-09-09 |
| 1235493743 | Kathleen Suzanne Leavitt | Marriage & Family Therapist | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2012-06-28 |
| 1144453051 | Valerie Ann Reynolds | Counselor | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2009-08-26 |
| 1447485594 | Kristen Peterca | Counselor | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2009-05-19 |
| 1134370265 | Ronn Jeffry Nelson II | Psychologist | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2008-10-07 |
| 1629285036 | Christopher James Hill | Marriage & Family Therapist | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2007-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295236628 | Ramon Benton | Counselor | 2951 Nw Division St Ste 120, Gresham, OR 97030-5293 | 2018-02-21 |
| 1316450265 | Philisia Roquez | Counselor | 621 Ne Kane Dr Apt 102, Gresham, OR 97030-5968 | 2017-11-14 |
| 1184142283 | Jami L Stephens | Counselor | 406 Ne 4th St Ste 110, Gresham, OR 97030-7496 | 2017-09-08 |
| 1770940645 | Kristen Brooke Beck | Counselor | 406 Ne 4th St Ste 126, Gresham, OR 97030-7496 | 2016-01-24 |
| 1932565363 | Cheyenne Marie Jones | Counselor | 254 Nw Burnside Rd Ste 230, Gresham, OR 97030-3836 | 2016-01-14 |
| 1679939920 | Alycia Smith | Counselor | 320 N Main Ave Ste 201d, Gresham, OR 97030-7242 | 2015-12-31 |
| 1538530159 | Jamie Saechao | Counselor | 429 Se 218th Ave, Gresham, OR 97030-8502 | 2015-10-08 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1346649860 | Jade Elisabeth Elaine Thayer | Counselor | 847 Se Francis Ave, Gresham, OR 97080-1343 | 2014-08-20 |
| 1639429137 | Janet Elaine Young | Counselor | 32300 Se Bluff Rd, Gresham, OR 97080-8822 | 2012-09-12 |
| Find all providers in GRESHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.