Provider Demographics
NPI:1992953277
Name:GAFFIELD, GARY EUGENE (DO)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:EUGENE
Last Name:GAFFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44416 DALLES RD
Mailing Address - Street 2:
Mailing Address - City:CONCRETE
Mailing Address - State:WA
Mailing Address - Zip Code:98237-9431
Mailing Address - Country:US
Mailing Address - Phone:360-853-7084
Mailing Address - Fax:
Practice Address - Street 1:44416 DALLES RD
Practice Address - Street 2:
Practice Address - City:CONCRETE
Practice Address - State:WA
Practice Address - Zip Code:98237-9431
Practice Address - Country:US
Practice Address - Phone:360-853-7084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1630207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine