Individual
GINA GUILLAUME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10373 NE HANCOCK ST STE 125, PORTLAND, OR 97220-3873
(503) 253-6754
(503) 253-8020
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
(503) 764-9042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD205674
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/27/2017
Last updated
01/25/2024
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