Gimmillaro, Terena D

Gimmillaro, Terena D is an individual health care provider with primary practice located at 4805 Ne Glisan St , Portland OR 97213-2933. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Gimmillaro, Terena D can be contacted via phone (503) 215-4860.

Contact Information

Primary practice address
4805 Ne Glisan St Portland OR 97213-2933
Phone: (503) 215-4860
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X DO173630 Oregon
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X DO173630 Oregon

Profile Details

NPI number 1235574955
LBN Legal business name Gimmillaro, Terena D
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2013
Last updated Oct 14th, 2020 - about 5 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 1235574955 NPPES
Oregon MEDICAID 500701579

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