Provider Demographics
NPI:1730421991
Name:GARDNER, ASHLEY (MD, MS, PHD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:GARDNER
Suffix:
Gender:F
Credentials:MD, MS, PHD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:VALENTINE GARDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3303 SW BOND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4501
Mailing Address - Country:US
Mailing Address - Phone:503-494-7246
Mailing Address - Fax:503-494-7635
Practice Address - Street 1:3303 SW BOND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4501
Practice Address - Country:US
Practice Address - Phone:503-494-7246
Practice Address - Fax:503-494-7635
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD183622207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology