Most Relevant Information
Provider Data
| NPI Number: | 1003294323 |
| Provider Name: | ELIZABETH GORDON MDIV, MSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/07/2015 |
| Last Updated: | 05/07/2015 |
Provider Practice Location
10011 SE DIVISION ST
STE 305
PORTLAND
OR
972661351
Practice Location Phone/Fax
| Phone: | 5033355975 |
| Fax: |
Provider Mailing Location
10011 SE DIVISION ST
STE 305
PORTLAND
OR
972661351
Provider Mailing Phone/Fax
| Phone: | 5033355975 |
| Fax: |