Individual
JEFFREY IRA GERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MDPHD
Contact information
Practice address
9155 SW BARNES RD, STE 204, PORTLAND, OR 97225-6625
(503) 297-7463
(503) 297-8835
Mailing address
PO BOX 821350, VANCOUVER, WA 98682-0030
(503) 283-5220
(503) 283-9527
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD16613
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010350
—
OR
01
—
018132001
BLUE CROSS
OR
05
—
1057847
—
WA
Enumeration date
11/15/2005
Last updated
01/13/2011
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