Individual
MRS. MIKI GOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2191 NW 2ND ST, MCMINNVILLE, OR 97128-9108
(503) 434-2824
Mailing address
215 PARK CT, NEWBERG, OR 97132-1011
(971) 237-7034
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
12498
OR
Other
Enumeration date
06/04/2007
Last updated
03/18/2009
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