# DQCGM OF OREGON LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GATEWAY DENTAL SURGERY CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326839507
- **Authorized official:** SHERRIE EDMONDSON (SR MANAGER LICENSING & CREDENTIALIN)
- **Authorized official phone:** (629) 999-5014

## Contact information

- **Practice address:** 10535 NE GLISAN ST STE 100, PORTLAND, OR 97220-4076
- **Practice address phone:** (971) 229-8777
- **Mailing address:** PO BOX 842674, LOS ANGELES, CA 90084-2674
- **Mailing address phone:** (629) 999-5014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/15/2025
- **Last updated:** 05/15/2025