Individual
MR. GORDON LEWIS BORDEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1007 KOALA AVE, OMAK, WA 98841-9247
(509) 826-6191
(509) 826-8416
Mailing address
1007 KOALA DRIVE, OMAK, WA 98841
(509) 826-6191
(509) 826-8416
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00003406
WA
Other
Enumeration date
03/05/2008
Last updated
03/05/2008
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