Individual
MR. GREGORY GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431-8404
(919) 428-4538
Mailing address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431-8404
(919) 428-4538
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
082205-1
NY
1041C0700X
Clinical Social Worker
Primary
083728-1
NY
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
10/06/2011
Last updated
12/08/2023
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