Individual
DR. GERALDINE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
900 SUNSET DR, LA GRANDE, OR 97850-1387
(541) 963-2328
(541) 975-5210
Mailing address
PO BOX 3290, LA GRANDE, OR 97850-7290
(541) 963-2328
(541) 975-5210
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
20A6134
CA
207RC0000X
Cardiovascular Disease Physician
7383A
WY
207RC0000X
Cardiovascular Disease Physician
822
NV
207RC0000X
Cardiovascular Disease Physician
Primary
DO194314
OR
207RC0000X
Cardiovascular Disease Physician
OP60308505
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123264900
—
WY
05
—
2016356
—
NV
05
—
500769777
—
OR
Enumeration date
08/19/2005
Last updated
08/13/2020
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