Individual
MR. VICTOR COLLINS GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011
(541) 826-2111
Mailing address
1111 LEFT FORK HUMBUG CREEK RD, JACKSONVILLE, OR 97530-9625
(541) 301-5502
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
0001174221
VA
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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