Individual
TIMOTHY JAMES GERKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, MAIL CODE SJH-2, PORTLAND, OR 97239-3011
(503) 494-4910
Mailing address
605 E FAIRFIELD ST, GLADSTONE, OR 97027-1712
(503) 309-0706
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200941580RN
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
201600750CRNA
OR
Other
Enumeration date
08/09/2013
Last updated
02/24/2016
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