Individual
MONICA J GULLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12710 SE DIVISION ST, PORTLAND, OR 97236
(503) 988-5558
Mailing address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-5558
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD185566
OR
Other
Enumeration date
07/06/2011
Last updated
04/08/2019
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