Healthcare Provider Details

I. General information

NPI: 1265475198
Provider Name (Legal Business Name): MARIA GIA GREGORIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10859 NW SUPREME CT
PORTLAND OR
97229-8816
US

IV. Provider business mailing address

10859 NW SUPREME CT
PORTLAND OR
97229-8816
US

V. Phone/Fax

Practice location:
  • Phone: 503-641-6429
  • Fax:
Mailing address:
  • Phone: 503-641-6429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number28253
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number26528
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: