Jessica Blair Gallo
Student in an Organized Health Care Education/Training Program in Portland, OR. Individual provider (NPI-1).
NPI number1184802001
StatusActive
Last updated in NPPESFeb 1, 2008
Details
- NPI
- 1184802001
- Entity type
- Individual (NPI-1)
- Name
- Jessica Blair Gallo
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 1, 2008
- Last updated
- Feb 1, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
1500 Ne Irving StSuite 250
Portland, OR 97232-2243
Phone 503-233-4356
Mailing address
3000 Sw Corbeth LnApt. 101
Troutdale, OR 97060-3177
Phone 503-484-3095
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