Individual
MS. GABRIELA LUCIANA LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(410) 933-6423
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
D97956
MD
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
MD221628
OR
Other
Enumeration date
03/26/2018
Last updated
08/07/2024
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