Individual
DR. JEROME S GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
635 CHURCH ST NE, SALEM, OR 97301-2402
(503) 399-9691
(503) 399-9401
Mailing address
635 CHURCH ST NE, SALEM, OR 97301-2402
(503) 399-9691
(503) 399-9401
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
682
OR
103TC0700X
Clinical Psychologist
682
OR
103TF0000X
Family Psychologist
Primary
682
OR
103TF0200X
Forensic Psychologist
682
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172437
—
OR
Enumeration date
01/24/2007
Last updated
09/11/2025
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