Provider Demographics
NPI:1871715714
Name:GUNDERSON, LAUNA DALROS (MD)
Entity type:Individual
Prefix:
First Name:LAUNA
Middle Name:DALROS
Last Name:GUNDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUNA
Other - Middle Name:MARIE
Other - Last Name:DALROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4805 NE GLISAN ST
Practice Address - Street 2:STE BG05
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2933
Practice Address - Country:US
Practice Address - Phone:503-215-2393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLL16198207R00000X
ORMD28411207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP00946514OtherRR MEDICARE - PH&S - OREGON (PMG)
OR241781Medicaid
ORR149215Medicare PIN