Individual
DR. PAUL NORTHROP GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, MAIL CODE MBS ATTN JULIE NIELSON, PORTLAND, OR 97239-3011
(503) 494-6101
(503) 494-1159
Mailing address
5530 SW 87TH AVE, PORTLAND, OR 97225-1716
(503) 292-4669
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD13963
OR
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD13963
OR
208M00000X
Hospitalist Physician
MD13963
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219154
—
OR
Enumeration date
06/19/2006
Last updated
12/12/2013
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