IndividualActive
Gennady Fortuna
NPI 1780204164 · Professional Counselor · Gladstone, OR
Provider details
- NPI number
- 1780204164
- Entity type
- Individual
- Primary specialty
- Professional CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- C6929 (OR)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
880 82nd Dr
Gladstone, OR 97027-1803
Phone: (503) 856-4798
Approximate (ZIP-level) locationGet directions
Mailing address
12200 Se Mcloughlin Blvd
Milwaukie, OR 97222-7281
Registry dates
- Enumerated
- 2020-04-25
- Last updated
- 2025-10-02
- Certified
- 2025-10-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.