Individual
JORDANA LIANE GAUMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5050 NE HOYT ST STE 651, PORTLAND, OR 97213-2954
(503) 935-8700
(503) 935-8701
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD28320
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1092690
—
WA
05
—
242408
—
OR
Enumeration date
05/15/2007
Last updated
12/07/2023
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