MEDICARE: GERRY F GERHART DC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2469	OR

General Provider Information

NPI Number	:	1285669853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERRY F GERHART DC PC

Provider Business Mailing Address
First Line	:	2035 SE BELMONT ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214
Country	:	US
Telephone Number	:	503-234-0119
Fax Number	:	503-234-6697

Provider Business Practice Location Address
First Line	:	2035 SE BELMONT ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214
Country	:	US
Telephone Number	:	503-234-0119
Fax Number	:	503-234-6697

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	GERRY F GERHART
Credential	:	DC
Telephone Number	:	503-234-0119

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/22/2020

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