Individual
DAVID E GANNETT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-2195
(503) 216-2196
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD20984
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150948
—
OR
05
—
8220857
—
WA
Enumeration date
08/11/2005
Last updated
09/16/2013
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