Individual provider Active NPI

Geoffrey Michael Gordon, PSYD

  • Clinical Psychologist
  • Eugene, OR
National Provider Identifier
1427524842
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2990 Issued in OR
Practice address
66 Club Rd Ste 210
Eugene, OR 97401-2599
Phone
(541) 393-5983
Fax
(541) 393-5984
NPI assigned
Oct 23, 2018
Last updated
Mar 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2990 OR Primary

Addresses

Primary practice location

66 Club Rd Ste 210
Eugene, OR 97401-2599

Mailing address

66 Club Rd Ste 210
Eugene, OR 97401-2599
Phone (541) 393-5983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190107000694 OR Practitioner - Clinical Psychologist 2668718081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7455 SW Beveland Rd
Tigard, OR 97223-8610
Phone (503) 624-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Clinical CurrentSince Dec 22, 2022 Accepting new patients
Western Psychological and Counseling Services LLC Clinical CurrentSince Dec 22, 2022 Accepting new patients

Locations

44 Club Rd
Ste 200
Eugene, OR 97401
Phone (254) 393-5983

66 Club Rd
Ste 120
Eugene, OR 97401
Phone (541) 345-2800

66 Club Rd
Ste 210
Eugene, OR 97401
Phone (541) 343-2569

66 Club Rd
Ste 360
Eugene, OR 97401
Phone (541) 240-2100

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

7455 SW Beveland Rd
Tigard, OR 97223
Phone (503) 624-2600

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.geoffreygordon@151848.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1427524842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CLUB RD STE 210",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012599",
            "telephone_number": "541-393-5983",
            "fax_number": "541-393-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 CLUB RD STE 210",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012599",
            "telephone_number": "541-393-5983",
            "fax_number": "541-393-5984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GEOFFREY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-23",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.