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NPI Code Detail

MEDICARE: GEOFFREY HALFORD GORDON M.D.

MEDICARE: GEOFFREY HALFORD GORDON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD14047OR

General Provider Information

NPI Number : 1093724155
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEOFFREY HALFORD GORDON M.D.
Provider Business Mailing Address
First Line : 3181 SOUTHWEST US VETERANS HOSPITAL RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-2999
Country : US
Telephone Number : 503-220-8262
Fax Number : 503-721-7807
Provider Business Practice Location Address
First Line : 3710 SW US VETERANS HOSPITAL RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-2964
Country : US
Telephone Number : 503-220-8262
Fax Number : 503-721-7807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2006
Last Update Date : 03/15/2026

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