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NPI Code Detail

MEDICARE: DR. CHRISTINE RENE GEBHARDT O.D.

MEDICARE:  DR. CHRISTINE RENE GEBHARDT  O.D.
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
1152W00000XOptometrist2571TOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801873310
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINE RENE GEBHARDT O.D.
Provider Business Mailing Address
First Line : PO BOX 22009
Second Line :
City : MILWAUKIE
State : OR
Zip : 97269-2009
Country : US
Telephone Number : 503-558-7372
Fax Number : 503-344-5140
Provider Business Practice Location Address
First Line : 5935 SE DIVISION ST
Second Line :
City : PORTLAND
State : OR
Zip : 97206-1470
Country : US
Telephone Number : 503-777-5546
Fax Number : 971-255-1764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2005
Last Update Date : 02/20/2021

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Directions to “ DR. CHRISTINE RENE GEBHARDT O.D.” Practice Location

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