Individual
COLIN D GAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9427 SW BARNES RD STE 395, PORTLAND, OR 97225-6652
(503) 216-6050
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD194039
OR
2086S0120X
Pediatric Surgery Physician
Primary
MD194039
OR
Other
Enumeration date
04/06/2012
Last updated
03/17/2022
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