SANDRA GILLGAM


Address: 11703 Ne Glisan St, Portland, OR 97220-2141
Phone: 5032537839

SANDRA GILLGAM (NPI# 1922139054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922139054
Entity Type Individual
Full Name SANDRA GILLGAM
Practice Address 11703 Ne Glisan St
Portland
OR 97220-2141
Practice Telephone 5032537839
Mailing Telephone 5032537839
Enumeration Date 2007-03-08
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 156FX1800X Technician/Technologist
Specialization: Optician
Eye and Vision Services Providers

Office Location

Street Address 11703 NE GLISAN ST
City PORTLAND
State OR
Zip Code 97220-2141

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Taxonomy Information

Taxonomy Code 156FX1800X
Grouping Eye and Vision Services Providers
Classification Technician/Technologist
Specialization Optician

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619530524 Christopher Morgan Wheaton Technician/Technologist 93 Washington Ave Unit 2, Portland, ME 04101-2618 2019-04-16
1609108968 Kathy Haywood Technician/Technologist 1017 Northcliff Dr, Portland, TX 78374-1918 2010-02-10
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1669621207 Reynolds Optical Technician/Technologist 800 Sw Alder, Portland, OR 97205-3107 2008-09-18
1235306911 Amy Roseanne Skucas Technician/Technologist 500 Multnomah St, Suite 100, Portland, OR 97232 2008-05-13
1497926463 Hallmark Opticians Technician/Technologist 1911ne Broadway, Portland, OR 97232-1501 2008-03-18
1053455782 Keeoli Corp Dba Vipeyes Technician/Technologist 1041 Brighton Ave, Portland, ME 04102-1042 2007-02-16
1245385160 Charles Marshall Technician/Technologist 1911 Ne Broadway St, Portland, OR 97232-1501 2007-01-23
1205984630 Weller Inc Technician/Technologist 2933 E Burnside St, Portland, OR 97214-1831 2007-01-08
1710048335 Derek James Buchanan Technician/Technologist 925 Sw Taylor St, Portland, OR 97205-2503 2006-12-13
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Competitor

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City PORTLAND
Zip Code 97220

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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