Provider Demographics
NPI:1225281249
Name:GAZELEY, MARGARET MAUDE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:MAUDE
Last Name:GAZELEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16865 BOONES FERRY ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035
Mailing Address - Country:US
Mailing Address - Phone:503-699-6464
Mailing Address - Fax:
Practice Address - Street 1:16865 BOONES FERRY ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035
Practice Address - Country:US
Practice Address - Phone:503-699-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200041006RN163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery