Individual provider · NPI-1

Amanda Gordon

Technician, Attendant Care Provider · Eugene, OR

NPI number1053968883
StatusActive
Last updated in NPPESAug 26, 2019

Details

NPI
1053968883
Entity type
Individual (NPI-1)
Name
Amanda Gordon
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 26, 2019
Last updated
Aug 26, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3747A0650X Technician, Attendant Care Provider–ORYes

Practice location

322 Anton Ct
Eugene, OR 97402-2410

Phone 458-205-7741 · Fax 541-607-7456

Mailing address

322 Anton Ct
Eugene, OR 97402-2410

Phone 458-205-7741 · Fax 541-607-7456

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