Gardner, Daniel Fitzgerald

Gardner, Daniel Fitzgerald is an individual health care provider with primary practice located at 19250 Sw 65Th Ave Ste 235 , Tualatin OR 97062-7745. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Gardner, Daniel Fitzgerald can be contacted via phone (503) 692-5650.

Contact Information

Primary practice address
19250 Sw 65Th Ave Ste 235 Tualatin OR 97062-7745
Phone: (503) 692-5650
Fax: (503) 692-7903
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD211065 Oregon

Profile Details

NPI number 1255863544
LBN Legal business name Gardner, Daniel Fitzgerald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2017
Last updated Nov 21st, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255863544 NPPES
Oregon MEDICAID 500728008
Oregon MEDICAID 2084358

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