Individual
MRS. JENNIFER S GALLARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPM
Contact information
Practice address
19255 SW 65TH AVE STE 220, TUALATIN, OR 97062-9717
(503) 885-0228
Mailing address
19255 SW 65TH AVE STE 220, TUALATIN, OR 97062-9717
(503) 885-0228
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
1000044
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210397
—
OR
Enumeration date
03/09/2007
Last updated
07/09/2007
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