Individual provider · Type 1 NPI

Diana Elizabeth Gwinn, DD1

Adult Care Home Facility · Portland, OR

NPI number 1386122687 Active

Practice location

16405 NE Fargo Cir
Portland, OR 97230-5513

Call (503) 484-7287 Map

Fax (503) 210-5974

Specialties and licenses

TaxonomyCodeLicense
Adult Care Home Facility Primary 311ZA0620X10465 (OR)

Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

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About NPI 1386122687

Diana Elizabeth Gwinn, DD1's National Provider Identifier is 1386122687, issued on Jul 30, 2018. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Portland, OR. The record was last updated on Jul 30, 2018.