Individual
GAIL BUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13007 NE GLISAN ST, PORTLAND, OR 97230-2545
(503) 215-7850
Mailing address
1232 NE 59TH AVE, PORTLAND, OR 97213-4204
(503) 473-4295
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
082012879LPN
OR
Other
Enumeration date
05/24/2016
Last updated
05/24/2016
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