Organization
GATEWAY EYE CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J CHESTLER M.D. (PRESIDENT)
(503) 252-2467
Entity
Organization
Contact information
Practice address
10502 NE WASCO ST, PORTLAND, OR 97220-3948
(503) 252-2467
(503) 252-0670
Mailing address
10502 NE WASCO ST, PORTLAND, OR 97220-3948
(503) 252-2467
(503) 252-0670
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013545
—
OR
Enumeration date
08/30/2007
Last updated
08/30/2007
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