Individual
DR. MARY GAIL PELLICCIOTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4855 SW WESTERN AVE, KAISER, BEAVERTON, OR 97005-3460
(503) 643-7565
Mailing address
4855 SW WESTERN AVE, KAISER, BEAVERTON, OR 97005-3460
(503) 643-7565
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD14245
OR
Other
Enumeration date
08/22/2006
Last updated
08/20/2007
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