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Individual

DAVID JOSEPH GAHTAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
1919 NW LOVEJOY ST, PORTLAND, OR 97209-1503
(509) 415-5600
Mailing address
15271 SE THORNTON DR, MILWAUKIE, OR 97267-2552

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01015
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500603044
OR
01
P00464824
RR MEDICARE
OR
Enumeration date
02/23/2006
Last updated
04/10/2024
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