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NPI Code Detail

MEDICARE: ANDREA L GORE CDP

MEDICARE: ANDREA L GORE CDP
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
11041C0700XClinical Social WorkerL5977OR
2101YA0400XAddiction (Substance Use Disorder) Counselor08-R-14OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174687537
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA L GORE CDP
Provider Business Mailing Address
First Line : 2051 KAEN RD
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-4035
Country : US
Telephone Number : 503-742-5300
Fax Number : 503-742-5979
Provider Business Practice Location Address
First Line : 998 LIBRARY CT
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-4041
Country : US
Telephone Number : 503-655-8401
Fax Number : 503-655-8429
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 12/03/2025

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Directions to “ ANDREA L GORE CDP” Practice Location

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