Provider Demographics
NPI:1780067660
Name:GYURICSKA, MAGDALENE (MD)
Entity type:Individual
Prefix:
First Name:MAGDALENE
Middle Name:
Last Name:GYURICSKA
Suffix:
Gender:F
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:PO BOX 22075
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97269-2075
Mailing Address - Country:US
Mailing Address - Phone:503-659-4988
Mailing Address - Fax:503-698-4018
Practice Address - Street 1:16144 SE HAPPY VALLEY TOWN CENTER DR STE 101
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-4257
Practice Address - Country:US
Practice Address - Phone:503-659-4988
Practice Address - Fax:503-698-4018
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301108416207Q00000X
ORMD185697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine