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NPI Code Detail

MEDICARE: ALEXANDRA GILLEN

MEDICARE: ALEXANDRA GILLEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse201400163RNOR

General Provider Information

NPI Number : 1134051774
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA GILLEN
Provider Business Mailing Address
First Line : 12590 SW BOWMONT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97225-5502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3710 SW US VETERANS HOSPITAL RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-2964
Country : US
Telephone Number : 503-220-8262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2026
Last Update Date : 05/29/2026

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Directions to “ ALEXANDRA GILLEN ” Practice Location

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