Individual
JACQUELINE GAMBEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
133 E MAIN ST, CARLTON, OR 97111
(503) 852-7147
Mailing address
2300 LANCASTER DR NE, SALEM, OR 97305-1223
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10623
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D10623
GENERAL DENTIST
OR
Enumeration date
04/19/2016
Last updated
09/25/2019
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