Basic Information
| Provider Information | |||||||||
| NPI: | 1942318407 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GILLINS | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3710SW US VETERANS HOSPITAL ROAD | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032208262 | ||||||||
| FaxNumber: | 5032203499 | ||||||||
| Practice Location | |||||||||
| Address1: | 3710 SW US VETERANS HOSPITAL RD | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972392964 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032208262 | ||||||||
| FaxNumber: | 5032203499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0809X | 085068119N6PMHNP-PP | OR | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult |
No ID Information.