Provider Demographics
NPI:1033208343
Name:GILSTER, JASON CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:CHRISTOPHER
Last Name:GILSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 NE NEFF RD STE 204
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4281
Mailing Address - Country:US
Mailing Address - Phone:541-382-8346
Mailing Address - Fax:541-382-5796
Practice Address - Street 1:7421 SW BRIDGEPORT RD STE 215
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-7707
Practice Address - Country:US
Practice Address - Phone:971-297-3007
Practice Address - Fax:503-598-7765
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD22087208600000X
WAMD60714285208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR138058Medicaid
WA8490328Medicaid
H12020Medicare UPIN
WAG8962182Medicare PIN
OR138649Medicare PIN