| Brandon Lee Gisi, | |
|
10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | |
| (503) 813-2000 | |
| Not Available |
| Full Name | Brandon Lee Gisi |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 10180 Se Sunnyside Rd, Clackamas, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508363003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | MD219224 (Oregon) | Primary |
| Entity Name | Martin Luther King Jr Community Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356899777 PECOS PAC ID: 8628359502 Enrollment ID: O20170109001311 |
| Mailing Address | Practice Location Address |
|---|---|
| Brandon Lee Gisi, 500 Ne Multnomah St Fl 11, Portland, OR 97232-2023 Ph: () - | Brandon Lee Gisi, 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 Ph: (503) 813-2000 |
Erik William Foss, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 10180 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-813-2000 | |
Dr. Zoltan A. Varro, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 10180 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 800-813-2000 | |
Dr. Clay Anthony Elrod, D.O. Radiology Medicare: Accepting Medicare Assignments Practice Location: 10180 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-652-2880 | |
Joshua Robert Hill, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 10180 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-652-2880 | |
Garry Roger Dion, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 10180 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-652-2880 | |
Jerry Everett King, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 10180 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-652-2880 | |
Mark Robert Hurt, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 10180 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-652-2880 |