Individual
DR. JUSTIN T GATHERCOAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5125 SKYLINE RD S, SALEM, OR 97306-9427
(800) 813-2000
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO166588
OR
207Q00000X
Family Medicine Physician
OS014673
PA
Other
Enumeration date
07/19/2010
Last updated
12/11/2025
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