Individual
JAY N GADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
2440 NW EDENBOWER BLVD, ROSEBURG, OR 97471-8847
(541) 957-1141
(541) 957-1466
Mailing address
2440 NW EDENBOWER BLVD, ROSEBURG, OR 97471-8847
(541) 957-1141
(541) 957-1466
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD20360
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150092
—
OR
Enumeration date
02/02/2006
Last updated
07/27/2011
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