Organization
CRAIG T GILLIS DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG GILLIS DO (PHYSICIAN)
(503) 850-9940
Entity
Organization
Contact information
Practice address
4103 MERCANTILE DR, LAKE OSWEGO, OR 97035-2556
(503) 850-9940
(503) 850-6709
Mailing address
4103 MERCANTILE DR, LAKE OSWEGO, OR 97035-2556
(503) 850-9940
(503) 850-6709
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
Other
Enumeration date
07/02/2019
Last updated
05/18/2020
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