Tashina Nicole Gordon, CRM, CADC-R

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

104 4TH Ave SW
Albany, OR 97321-2804

Phone

(541) 967-3819

NPI assigned

May 12, 2022

Last updated

Nov 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1487390399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973210031",
            "telephone_number": "541-220-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 4TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973212804",
            "telephone_number": "541-967-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "TASHINA",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "CRM, CADC-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Samaritan Hospital Corvallis (Samaritan Mental Health- Albany)
• Good Samaritan Hospital Corvallis (Samaritan Occupational Medicine-Albany)
• Good Samaritan Hospital Corvallis (Samaritan Home Health Services)
• Tammy Lee Goodman, BC
• Walter F Goodwillie, MD
• Anne L. Gourley, BS
• Heidi R Graham, RD
• Mandy Graham
• Teresa Ann Graham, LCSW
• Christina Roberta Granillo, NCMA

• Social Worker in Albany, OR
• Providers in Albany, OR by specialty
• Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.