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Individual

DR. ALEXANDRA GATELY CORNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, OHSU PEDIATRICS, PORTLAND, OR 97239-3011
(503) 494-5476
Mailing address
3181 SW SAM JACKSON PARK RD, OHSU PEDIATRICS, PORTLAND, OR 97239-3011

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
249817
NY
2080P0214X
Pediatric Pulmonology Physician
15287
NH
2080P0214X
Pediatric Pulmonology Physician
Primary
161586
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32000767
NH
Enumeration date
12/06/2006
Last updated
03/15/2013
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