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Individual

JON M GERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4805 NE GLISAN ST STE 6N60, PORTLAND, OR 97213-2933
(503) 281-0561
(503) 416-7377
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
100886
AK
208600000X
Surgery Physician
Primary
MD191079
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2164659
WA
05
500783479
OR
Enumeration date
04/07/2010
Last updated
12/07/2023
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