Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | MD035632 | DC |
Y | 2086S0120X | Pediatric Surgery | MD161804 | OR |
NPI | 1043300502 |
---|---|
Provider Name | Cynthia Ann Gingalewski |
First Address | Portland, OR 97227-1654 |
Second Address | Portland, OR 97227-1654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 02/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H10797 | (02) |