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Organization

ANDALUZ BIRTH CENTER P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JENNIFER S GALLARDO CPM (DIRECTOR)
(503) 885-0228
Entity
Organization

Contact information

Practice address
19255 SW 65TH AVE STE 220, TUALATIN, OR 97062-9717
(503) 885-0228
(503) 691-5594
Mailing address
19255 SW 65TH AVE STE 220, TUALATIN, OR 97062-9717
(503) 885-0228
(503) 691-5594

Taxonomy

Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
Primary
297219
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
297219
OR
Enumeration date
03/09/2007
Last updated
08/22/2020
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