Individual
FREDERICK GOULDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2222 COBURG RD STE 100, EUGENE, OR 97401-4988
(541) 858-8170
(541) 858-8167
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
PROFESSIONALLICENSE
—
Other
Enumeration date
03/09/2016
Last updated
06/14/2024
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