Individual
JAECELLE GUADIZ GALENIECE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1003 PROVIDENCE DR STE 110, NEWBERG, OR 97132
(503) 537-5900
(503) 537-5959
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD188938
OR
Other
Enumeration date
06/16/2014
Last updated
10/02/2020
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