Individual
MRS. GAYLE MARGARET MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADULT NURSE PRACTITI
Contact information
Practice address
5100 SW MACADAM AVE, SUITE 200, PORTLAND, OR 97239-6102
(971) 202-5500
(971) 202-5555
Mailing address
5100 SW MACADAM AVE, SUITE 200, PORTLAND, OR 97239-6102
(971) 202-5500
(971) 202-5555
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
098006088N3 ANP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287406
—
OR
01
—
GM01 067593003
BLUE CROSS/SHIELD PIN
OR
Enumeration date
06/15/2006
Last updated
01/23/2013
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