Individual
JEFFREY GILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1016 TACOMA AVE, SUNNYSIDE, WA 98944-2263
(509) 837-1500
Mailing address
PO BOX 719, SUNNYSIDE, WA 98944-0719
(509) 837-1617
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
40260
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
249722504
PERSONAL PTAN
OK
01
—
41713
STATE LICENSE
MT
Enumeration date
01/04/2007
Last updated
03/07/2025
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