Healthcare Provider Details

I. General information

NPI: 1619472487
Provider Name (Legal Business Name): MARGO ORA KALLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGO ELSA GILBERT

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10180 SE SUNNYSIDE RD
CLACKAMAS OR
97015-8970
US

IV. Provider business mailing address

500 NE MULTNOMAH ST STE 100
PORTLAND OR
97232-2099
US

V. Phone/Fax

Practice location:
  • Phone: 800-813-2000
  • Fax:
Mailing address:
  • Phone: 800-813-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD203992
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: