1790321545 NPI number — GABRIEL TAYLOR-PARSONS APRN, PMHNP

Table of content: GABRIEL TAYLOR-PARSONS APRN, PMHNP (NPI 1790321545)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790321545 NPI number — GABRIEL TAYLOR-PARSONS APRN, PMHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAYLOR-PARSONS
Provider First Name:
GABRIEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN, PMHNP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PARSONS
Provider Other First Name:
GABRIEL
Provider Other Middle Name:
ALEXANDER
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN, PMHNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790321545
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12725 SW MILLIKAN WAY STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEAVERTON
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97005-1687
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
971-319-1592
Provider Business Mailing Address Fax Number:
971-999-0925

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12725 SW MILLIKAN WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAVERTON
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97005-1678
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
971-319-1592
Provider Business Practice Location Address Fax Number:
971-999-0925
Provider Enumeration Date:
11/26/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  0024181600 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: AP61229224 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: APRN11021941 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 202106402NP-PP , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)