Individual
MR. GARY ROSS GEDDES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12400 NW CORNELL RD, PORTLAND, OR 97229-5616
(503) 626-0939
(503) 626-6161
Mailing address
12400 NW CORNELL RD, PORTLAND, OR 97229-5616
(503) 626-0939
(503) 626-6161
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD101770
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073338
—
OR
Enumeration date
06/09/2006
Last updated
07/08/2007
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