Southern Oregon Psychiatry, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SOUTHERN OREGON PSYCHIATRY, LLC

Practice address

1104 E Jackson St
Medford, OR 97504-7029

Phone

(541) 313-3617

Fax

(769) 235-0747

NPI assigned

Sep 4, 2021

Last updated

Sep 10, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rachael Gordon, PMHNPNPI 1306327507

Title

Medical Director/Founder

Phone

(541) 313-3617

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rachael Gordon, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Jose, CA
  • NPI 1306327507
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1114695962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047029",
            "telephone_number": "541-313-3617",
            "fax_number": "769-235-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047029",
            "telephone_number": "541-313-3617",
            "fax_number": "769-235-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OREGON PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-04",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/FOUNDER",
        "authorized_official_telephone_number": "541-313-3617",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Southern Oregon Sleep Diagnostics (Mountain Sleep Lab)
• Southern Oregon Sleep Diagnostics LLC
• Southern Oregon Spine Care, P.C.
• Southern Oregon Trauma and Emergency Services, LLC
• Southern Oregon Wellness Clinic, LLC (Southern Oregon Medical Clinic)

• Psychiatric/Mental Health Nurse Practitioner in Medford, OR
• Providers in Medford, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.