Individual
GEOFFREY M GULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
335 SE 8TH AVE, HILLSBORO, OR 97123-4246
(513) 681-1109
(503) 681-1835
Mailing address
PO BOX 28130, PORTLAND, OR 97228-8130
(503) 681-1109
(503) 681-1835
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD24515
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227540
—
OR
Enumeration date
11/28/2006
Last updated
09/21/2009
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