Provider Demographics
NPI:1922538982
Name:GILMORE, RODNEY C (CLINICAL COUNSELOR)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:C
Last Name:GILMORE
Suffix:
Gender:M
Credentials:CLINICAL COUNSELOR
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:36 SW NYE ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-3821
Mailing Address - Country:US
Mailing Address - Phone:541-574-5960
Mailing Address - Fax:541-265-0601
Practice Address - Street 1:51 SW LEE ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-3823
Practice Address - Country:US
Practice Address - Phone:541-574-5960
Practice Address - Fax:541-265-0601
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health