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Individual

DR. DAVID GISSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2846 NW ARIEL TER, PORTLAND, OR 97210-3119
(775) 883-2202
(775) 883-0797
Mailing address
2846 NW ARIEL TER, PORTLAND, OR 97210-3119
(775) 315-4128
(775) 883-0797

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
5549
NV
207L00000X
Anesthesiology Physician
G54203
CA
207L00000X
Anesthesiology Physician
Primary
MD158172
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050007310
RAILROAD MEDICARE
05
2013014
NV
Enumeration date
07/28/2006
Last updated
11/03/2017
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