Individual
THEODORE N GONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
46314 TIMINE WAY, PENDLETON, OR 97801-9417
(541) 966-9830
Mailing address
PO BOX 160, PENDLETON, OR 97801-0160
(541) 966-9830
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000106181
OR
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
About Stedi
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