Basic Information
| Provider Information | |||||||||
| NPI: | 1235422023 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DHAMI | ||||||||
| FirstName: | GURLEEN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10123 SE MARKET ST | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972162532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032572500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8821 NE 5TH ST | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605141900 | ||||||||
| FaxNumber: | 3605141910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2011 | ||||||||
| LastUpdateDate: | 07/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | BP1-0040908 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2085R0001X | MD178806 | OR | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | ML60281693 | WA | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.