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1972338515
BRENT JOHNSTON GORDON
ASTORIA, OR
NPI
1972338515
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-09-04
Last Update Date
2024-09-04
Business Address
BRENT JOHNSTON GORDON
115 W BOND ST
ASTORIA, OR 97103-6009
Phone number: 503-325-5722
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Mailing Address
BRENT JOHNSTON GORDON
65 N HIGHWAY 101 STE 204
WARRENTON, OR 97146-9371
Phone number: 503-325-5722
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