Healthcare Provider Details

I. General information

NPI: 1851200935
Provider Name (Legal Business Name): ALEJANDRO GONZALEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 UNION ST NE STE 205
SALEM OR
97301-2418
US

IV. Provider business mailing address

234 WHITESELL AVE W APT 102
MONMOUTH OR
97361-1044
US

V. Phone/Fax

Practice location:
  • Phone: 503-991-5522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: