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Individual

GREGORY LOUIS MONETA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7810
Mailing address
3181 SW SAM JACKSON PARK RD # OP11, PORTLAND, OR 97239-3098
(503) 494-7593
(503) 346-8081

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
15752
OR
2086S0129X
Vascular Surgery Physician
Primary
MD15752
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
060509
OR
Enumeration date
08/03/2006
Last updated
03/26/2019
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