# GO GENTLY MEDICAL GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891397931
- **Authorized official:** VERONICA E FEDJUR (NATIONAL DIR OF PAYER CONTRACTS)
- **Authorized official phone:** (801) 325-6181

## Contact information

- **Practice address:** 10365 SE SUNNYSIDE RD STE 340, CLACKAMAS, OR 97015-5751
- **Practice address phone:** (503) 698-9811
- **Practice address fax:** (503) 698-8988
- **Mailing address:** 10365 SE SUNNYSIDE RD STE 340, CLACKAMAS, OR 97015-5751
- **Mailing address phone:** (503) 698-9811
- **Mailing address fax:** (503) 698-8988

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/13/2020
- **Last updated:** 11/13/2020