Individual
GORDON S MACMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
31700 FAYETTEVILLE DR, SHEDD, OR 97377-9779
(503) 208-9004
(971) 236-8080
Mailing address
18600 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-6723
(971) 255-0658
(971) 236-8080
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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