Individual
DOUGLAS VANGORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2245 NW SHEVLIN PARK RD, BEND, OR 97703-7195
(541) 382-3344
Mailing address
2200 NE NEFF RD, SUITE 200, BEND, OR 97701-4283
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
15-00002769
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134170
—
OR
Enumeration date
06/02/2016
Last updated
06/02/2016
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