Individual
GARY A BURGOINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19250 SW 65TH AVE STE 325, TUALATIN, OR 97062-7452
(503) 855-1600
(503) 855-1609
Mailing address
7650 SW BEVELAND RD STE 200, PORTLAND, OR 97223-8692
(503) 601-3615
(503) 646-1683
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD24939
OR
207VG0400X
Gynecology Physician
Primary
MD24939
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276051
—
OR
01
—
R119567
MEDICARE PTAN
OR
Enumeration date
11/04/2005
Last updated
01/28/2026
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