Individual
BRENT M GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC I
Contact information
Practice address
5505 S PACIFIC HWY, PHOENIX, OR 97535
(541) 326-4905
(541) 608-2888
Mailing address
1003 E MAIN ST STE 104, MEDFORD, OR 97504-7140
(541) 326-4905
(541) 608-2888
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/16/2016
Last updated
07/03/2018
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