Healthcare Provider Details

I. General information

NPI: 1902865124
Provider Name (Legal Business Name): KAREN ELISE GASPARDI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 N 5TH ST
LEBANON OR
97355-2875
US

IV. Provider business mailing address

675 N 5TH ST
LEBANON OR
97355-2875
US

V. Phone/Fax

Practice location:
  • Phone: 541-451-6282
  • Fax: 541-812-2040
Mailing address:
  • Phone: 541-451-6282
  • Fax: 541-812-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG63379
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD161345
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: