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General NPI Number Information
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NPI Number | 1407851363
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Entity Type | Individual
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Provider Name | BERNARD A GASCH MD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 9427 SW BARNES RD SUITE 495
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City | PORTLAND
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State | OR
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Zip | 97225-6652
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Country | US
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Telephone | 503-297-3440
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Fax | 503-297-4584
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Provider Business Mailing Address
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Address Line | 9427 SW BARNES RD SUITE 495
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City | PORTLAND
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State | OR
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Zip | 97225-6652
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Country | US
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Telephone | 503-297-3440
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Fax | 503-297-4584
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD24345
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207NI0002X
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Taxonomy Name | Clinical & Laboratory Dermatological Immunology Physician
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License Number | MD24345
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 207NI0002X
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Taxonomy Name | Clinical & Laboratory Dermatological Immunology Physician
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License Number | MD00041910
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | MD24345
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | MD00041910
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | MD24345
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License Number State | OR
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Taxonomy #7
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | MD00041910
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License Number State | WA
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Taxonomy #8
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD00041910
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License Number State | WA
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