Individual
JASON A GALLEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
7916 SE FOSTER RD STE 201, PORTLAND, OR 97206-4289
(503) 374-3724
Mailing address
PO BOX 16756, PORTLAND, OR 97292-0756
(503) 374-3724
(503) 208-2596
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
18-CRM-128
OR
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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