Individual
NICHOLAS LANDAU GIDEONSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 VILLAGE DR, COTTAGE GROVE, OR 97424-9700
(541) 767-5200
(541) 767-5310
Mailing address
1400 SE OAK ST, PORTLAND, OR 97214-1430
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD17811
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063743
—
OR
Enumeration date
07/31/2006
Last updated
10/14/2024
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