Organization
MICHAEL P. GARDNER, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY BANTA (OFFICE MANAGER)
(503) 783-0208
Entity
Organization
Contact information
Practice address
19260 SW 65TH AVE STE 310, TUALATIN, OR 97062-5710
(503) 692-1200
(503) 692-1220
Mailing address
19260 SW 65TH AVE STE 310, TUALATIN, OR 97062-5710
(503) 692-1200
(503) 692-1220
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MD22270
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288387
—
OR
Enumeration date
11/17/2015
Last updated
01/29/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up