Individual
CHARLOTTE P GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
5234 SW PHILOMATH BOULEVARD, CORVALLIS, OR 97333-1042
(541) 768-4970
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
159864
OR
363A00000X
Physician Assistant
PA201
AK
Other
Enumeration date
10/20/2006
Last updated
11/09/2020
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