Gordon Paul Canzler, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO15150 Issued in OR

Practice address

400 NE Roberts Ave
Gresham, OR 97030-7464

Phone

(503) 665-9144

Fax

(503) 665-6404

NPI assigned

Sep 23, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valeria Health, LLC

  • Registered Dietitian
  • Portland, OR
  • NPI 1225508369
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1114913183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NE ROBERTS AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307464",
            "telephone_number": "503-665-9144",
            "fax_number": "503-665-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE ROBERTS AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307464",
            "telephone_number": "503-665-9144",
            "fax_number": "503-665-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANZLER",
        "first_name": "GORDON",
        "middle_name": "PAUL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO15150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205823",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ben F Campbell
• Sadie A Campbell, PSS/QMHA-I
• Sarah E Campsey, QMHP
• Marshall Albert Canizalez, AU.D
• Garry W Cannard, D.C.
• Thao Cao, DMD
• Tiauna Capel
• Christina Caputo, LMT L.AC.
• Kirstin Card, LMT
• Sarah Carl, LMT

• Family Medicine Physician in Gresham, OR
• Providers in Gresham, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.