Provider Demographics
NPI:1205849791
Name:GILBERT, WAYNE FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:FRANCIS
Last Name:GILBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9427 SW BARNES RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6652
Mailing Address - Country:US
Mailing Address - Phone:503-203-2176
Mailing Address - Fax:503-203-2181
Practice Address - Street 1:9427 SW BARNES RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6652
Practice Address - Country:US
Practice Address - Phone:503-203-2040
Practice Address - Fax:503-203-2181
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD15613208600000X
WAMD00034877208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery