Individual
JORDAN MATTHEW GOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 292-9108
(503) 292-0346
Mailing address
PO BOX 25180, PORTLAND, OR 97298-0180
(503) 292-9108
(503) 292-0346
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
175201
OR
2085R0202X
Diagnostic Radiology Physician
N3688
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323504601
—
TX
Enumeration date
07/19/2007
Last updated
06/30/2016
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