Basic Information
Provider Information
NPI: 1215348875
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GORMAN
FirstName: MARGARET
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7650 SW BEVELAND RD STE 200
Address2:  
City: PORTLAND
State: OR
PostalCode: 972238692
CountryCode: US
TelephoneNumber: 5036013615
FaxNumber: 5036461683
Practice Location
Address1: 10566 SE WASHINGTON ST
Address2:  
City: PORTLAND
State: OR
PostalCode: 97216
CountryCode: US
TelephoneNumber: 5037343800
FaxNumber: 5037343808
Other Information
ProviderEnumerationDate: 05/16/2014
LastUpdateDate: 07/25/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XMD188586ORY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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