Individual
DANIEL FITZGERALD GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19250 SW 65TH AVE STE 235, TUALATIN, OR 97062-7745
(503) 692-5650
(503) 692-7903
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
Primary
MD211065
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2084358
—
WA
05
—
500728008
—
OR
Enumeration date
03/28/2017
Last updated
11/12/2024
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