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Individual

DR. JIM ALAN GOSEWEHR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12123 SW 69TH AVE, TIGARD, OR 97223-8514
(971) 708-7600
(971) 371-5230
Mailing address
1498 SE TECH CENTER PL STE 240, VANCOUVER, WA 98683-5508

Taxonomy

Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
MD19412
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
074919
OR
05
1014914
WA
Enumeration date
05/24/2005
Last updated
07/17/2023
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