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Individual

DR. AMY K GILLCRIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1750 BLANKENSHIP RD, SUITE 200, WEST LINN, OR 97068-5101
(503) 908-1590
(503) 723-2862
Mailing address
18603 WILLAMETTE DR, SUITE 200, WEST LINN, OR 97068-1705
(503) 908-1590
(503) 723-2862

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD21800
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
139378
OR
01
P00252474
RR MEDICARE
OR
Enumeration date
06/21/2006
Last updated
03/06/2016
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