Healthcare Provider Details

I. General information

NPI: 1619028693
Provider Name (Legal Business Name): STEVEN P GABEL, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12115 SW 70TH AVE STE 200
TIGARD OR
97223
US

IV. Provider business mailing address

12115 SW 70TH AVE STE 200
TIGARD OR
97223-9648
US

V. Phone/Fax

Practice location:
  • Phone: 503-693-1118
  • Fax: 503-893-3127
Mailing address:
  • Phone: 503-693-1118
  • Fax: 503-893-3127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberMD23085
License Number StateOR

VIII. Authorized Official

Name: DR. STEVEN P GABEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 503-648-8971