GINA M BULLOCK


Address: 3508 Ne Broadway St, Portland, OR 97232-1821
Phone: 5032828777

GINA M BULLOCK (NPI# 1255440020) 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) 1255440020
Entity Type Individual
Full Name GINA M BULLOCK
Credential DPM
Practice Address 3508 Ne Broadway St
Portland
OR 97232-1821
Practice Telephone 5032828777
Practice Fax Number 5032828853
Mailing Telephone 5032828777
Mailing Fax Number 5032828853
Enumeration Date 2006-08-29
Last Update Date 2008-05-06
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 213ES0103X Podiatrist
Specialization: Foot & Ankle Surgery
DP00244 OR Podiatric Medicine & Surgery Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
OR DEA # BB3746748 01
OR 083431 05

Office Location

Street Address 3508 NE BROADWAY ST
City PORTLAND
State OR
Zip Code 97232-1821

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457498438 Broadway Foot & Ankle Clinic, PC Podiatrist 3508 Ne Broadway St, Portland, OR 97232-1821 2007-01-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1881293215 Oregon Change Clinic Clinic/Center 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 2020-10-17
1154969947 Lori Kristen Miracle Acupuncturist Kwan Yin Healing Arts Center East Inc, 3115 Ne Sandy Blvd. Suite 231, Portland, OR 97232 2019-12-12
1194285411 Onampai Modina Soondarotok Student in an Organized Health Care Education/Training Program Ipp, Oregon Health & Science University, 2214 Lloyd Center, Portland, OR 97232 2019-03-22
1003399635 Cathleen Nicole Wenberg Social Worker 1839 Ne Couch St, Portland, OR 97232 2018-09-10
1508350760 Float North Acupuncturist 1617 Ne 17th Ave., Portland, OR 97232 2018-06-20
1629560719 Rachael Lee Walters Doula 3005 Ne Hoyt St, Portland, OR 97232 2018-06-04
1225529431 Jason Sutherland Social Worker 707 Ne Couch, Portland, OR 97232 2018-05-23
1770089245 Richard Farwell Leman Family Medicine 800 Ne Oregon St., Suite 772, Portland, OR 97232 2018-04-03
1952803413 Aleksandra Giedowyn Md PC Family Medicine 1923 Ne Broadway Street Suite 2, Portland, OR 97232 2018-03-01
1639680374 Amanda Matteo Counselor 20 Ne 10th Ave, Portland, OR 97232 2017-10-20
Find all providers in zip 97232

Taxonomy Information

Taxonomy Code 213ES0103X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist
Specialization Foot & Ankle Surgery

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1386051803 Southwest Podiatry Center LLC Podiatrist 9370 Sw Greenburg Rd Ste 102, Portland, OR 97223-5428 2014-07-16
1386884237 Lopa Dalmia Podiatrist 12400 Nw Cornell Rd Ste 201, Portland, OR 97229-5689 2009-03-04
1679743876 Brandi S. Myers Dpm, LLC Podiatrist 7836 Se 13th Ave, Portland, OR 97202-6350 2008-03-04
1093921975 Brian M. Bowen Podiatrist 1717 Ne 42nd Ave, Suite 3300, Portland, OR 97213-1569 2007-05-15
1689700486 Brandi Sue Myers Podiatrist 5225 Se 28th Ave, Portland, OR 97202-4506 2007-02-26
1982647467 Thomas R Palmer Podiatrist 6108 Ne Glisan St, Portland, OR 97213-3864 2006-06-13
1962454934 Clifford Donald Mah Podiatrist 12400 Nw Cornell Rd, Suite 201, Portland, OR 97229-5693 2006-05-17
1538149471 Christopher Gerard Pingitore Podiatrist 51 Sewall St Ste 2, Portland, ME 04102-2644 2006-01-18
1194705038 John Henry Dorsey Jr. Podiatrist 195 Fore River Parkway, Suite 120, Portland, ME 04102 2006-01-18
1285624874 John B Perry Podiatrist 1711 Congress St, Portland, ME 04102-1962 2005-10-25
Find all providers in PORTLAND

Competitor

Search similar providers

City PORTLAND
Zip Code 97232

Improve Information

Please comment or provide details below to improve the information on GINA M BULLOCK.

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.

Trending Searches