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Contact Information

JEROME S GORDON, PhD
635 CHURCH ST NE
SALEM, OR97301-2402
 Phone: 503-399-9691
 Fax: 503-399-9401
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

103TF0000X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Forensic

103TF0200X 62 Psychologist, Clinical
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JEROME S GORDON · (Male)

NPI Number 1427103886
Status Active
Credentials PhD
Entity Individual
Enumeration date 01/24/2007
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Yes
Identifiers
  • OR License # 682
  • OR Medicaid 172437
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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