Organization
NORTHWEST COSMETIC SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY LYLE GALLAGHER M.D. (MANAGER/MEMBER)
(417) 283-1845
Entity
Organization
Contact information
Practice address
777 SW MILL VIEW WAY, SUITE 100, BEND, OR 97702-1140
(541) 388-1022
(541) 322-7002
Mailing address
777 SW MILL VIEW WAY STE 250, BEND, OR 97702-1140
(541) 728-3184
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD21961
OR
Other
Enumeration date
01/08/2008
Last updated
01/02/2020
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