Provider Demographics
NPI:1730363920
Name:GEBO, INC.
Entity type:Organization
Organization Name:GEBO, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/ BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:DAVIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANAHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-469-9824
Mailing Address - Street 1:8118 SW HALL BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-6446
Mailing Address - Country:US
Mailing Address - Phone:503-469-9824
Mailing Address - Fax:503-469-9324
Practice Address - Street 1:8118 SW HALL BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-6446
Practice Address - Country:US
Practice Address - Phone:503-469-9824
Practice Address - Fax:503-469-9324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR271452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR102596Medicare PIN
ORT68037Medicare UPIN