IndividualActive
Brent Gordon, CADC I
NPI 1417318577 · Addiction (Substance Use Disorder) Counselor · Phoenix, OR
Provider details
- NPI number
- 1417318577
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Credential
- CADC I
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
5505 S Pacific Hwy
Phoenix, OR 97535
Phone: (541) 326-4905
Fax: (541) 608-2888
Approximate (ZIP-level) locationGet directions
Mailing address
1003 E Main St Ste 104
Medford, OR 97504-7140
Registry dates
- Enumerated
- 2016-03-16
- Last updated
- 2018-07-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.