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General NPI Number Information
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NPI Number | 1891677506
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Entity Type | Individual
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Provider Name | JOSUE GOMEZ MSW
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Gender | Male
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 6605 SE LAKE RD
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City | MILWAUKIE
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State | OR
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Zip | 97222-2161
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Country | US
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Telephone | 503-655-8471
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Fax | 503-655-8471
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Provider Business Mailing Address
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Address Line | 150 NW 15TH ST. GRESHAM, OR 97030 150 NW 15TH ST. GRESHAM, OR 97030
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City | GRESHAM
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State | OR
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Zip | 97030
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Country | US
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Telephone | 503-560-0714
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | OR
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