Provider Demographics
NPI:1891053088
Name:GELLER, ALINA (DO)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:GELLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALINA
Other - Middle Name:
Other - Last Name:TARNOVSKAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:7650 SW BEVELAND RD
Mailing Address - Street 2:STE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8692
Mailing Address - Country:US
Mailing Address - Phone:503-601-3615
Mailing Address - Fax:503-646-1683
Practice Address - Street 1:1003 N PROVIDENCE DR STE 340
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-7521
Practice Address - Country:US
Practice Address - Phone:503-538-2698
Practice Address - Fax:503-554-9328
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277353207V00000X
OR156918207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500650104Medicaid