Forest Gauthier
Physician Assistant in Portland, OR. Individual provider (NPI-1).
NPI number1255165643
StatusActive
Last updated in NPPESAug 28, 2024
Details
- NPI
- 1255165643
- Entity type
- Individual (NPI-1)
- Name
- Forest Gauthier
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 28, 2024
- Certification date
- Aug 28, 2024
- Last updated
- Aug 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
12121 E Burnside StPortland, OR 97216-3737
Phone 971-361-7700
Mailing address
232 Nw 6th AvePortland, OR 97209-3609
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