Individual
GARY Y OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9427 SW BARNES RD STE 593, PORTLAND, OR 97225-6640
(503) 216-8670
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD00043345
WA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD17125
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020714
—
OR
Enumeration date
08/22/2005
Last updated
03/22/2021
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