Organization
GOLDSTAR VASCULAR ACCESS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ILNITSKIY RN (PRESIDENT)
(503) 516-9205
Entity
Organization
Contact information
Practice address
2870 NE HOGAN DR, STE E #205, GRESHAM, OR 97030
(150) 351-6920
Mailing address
1871 SE IRONWOOD WAY, GRESHAM, OR 97080-3002
15035169205
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
06/20/2017
Last updated
06/20/2017
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