Individual
TAMELA J DONNELLY-GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
5050 NE HOYT ST, SUITE 255, PORTLAND, OR 97213-2991
(503) 231-0407
Mailing address
5050 NE HOYT ST, SUITE 255, PORTLAND, OR 97213-2991
(503) 231-0407
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
LL16674
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL16674
OREGON PA LICENSE
OR
Enumeration date
02/22/2007
Last updated
07/08/2007
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