Provider Demographics
NPI:1366629925
Name:GYNECOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:GYNECOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:DARM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-292-9099
Mailing Address - Street 1:9427 SW BARNES RD
Mailing Address - Street 2:SUITE 599
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6652
Mailing Address - Country:US
Mailing Address - Phone:503-292-9099
Mailing Address - Fax:503-384-0872
Practice Address - Street 1:9427 SW BARNES RD
Practice Address - Street 2:SUITE 599
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6652
Practice Address - Country:US
Practice Address - Phone:503-292-9099
Practice Address - Fax:503-384-0872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD11739174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287048Medicaid
C92476Medicare UPIN
107982Medicare PIN
E55199Medicare UPIN
OR287048Medicaid