Gullerud, Joseph Robert

Gullerud, Joseph Robert is an individual health care provider with primary practice located at 9155 Sw Barnes Rd Ste 536 , Portland OR 97225-6785. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Gullerud, Joseph Robert can be contacted via phone (503) 935-8100.

Contact Information

Primary practice address
9155 Sw Barnes Rd Ste 536 Portland OR 97225-6785
Phone: (503) 935-8100
Fax: (503) 935-8110
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA182582 Oregon

Profile Details

NPI number 1710393723
LBN Legal business name Gullerud, Joseph Robert
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2014
Last updated Nov 22nd, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710393723 NPPES
Washington MEDICAID 2078286
Washington MEDICAID 500724113

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