Individual
DR. KELLY DEAN GUBLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
501 N GRAHAM, SUITE #580, PORTLAND, OR 97227
(503) 528-0704
(503) 528-0708
Mailing address
501 N GRAHAM, SUITE #580, PORTLAND, OR 97227
(503) 528-0704
(503) 528-0708
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
20A4923
CA
208600000X
Surgery Physician
Primary
DO23244
OR
208600000X
Surgery Physician
OP00000951
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287256
—
OR
Enumeration date
01/30/2006
Last updated
08/25/2007
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