Individual
DR. SHANE MATTHEW GJESDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 ELM ST SW, SUITE 200, ALBANY, OR 97321-1956
(541) 812-4850
(541) 812-4889
Mailing address
PO BOX 1188, CORVALLIS, OR 97339-1188
(541) 812-4850
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD29109
OR
Other
Enumeration date
08/15/2005
Last updated
11/03/2020
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