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Individual

GREGORY M STANLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1715 E 12TH ST, THE DALLES, OR 97058-3136
(541) 296-2294
Mailing address
1715 E 12TH ST, THE DALLES, OR 97058-3136
(541) 296-2294

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD24256
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
226813
OR
05
8358327
WA
Enumeration date
10/11/2005
Last updated
10/19/2020
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