Individual
DR. GARY EUGENE STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
387 N 5TH STREET, WOODBURN, OR 97071-4637
(503) 982-3781
(503) 982-8696
Mailing address
387 N 5TH STREET, WOODBURN, OR 97071-4637
(503) 982-3781
(503) 982-8696
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD 13446
OR
208D00000X
General Practice Physician
MD 42119
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176909
—
OR
Enumeration date
02/15/2007
Last updated
07/09/2007
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