Provider Demographics
NPI:1710871652
Name:DULLIN-HESS, GORDON MICHAEL
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:MICHAEL
Last Name:DULLIN-HESS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 HIGHWAY 7 STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5808
Mailing Address - Country:US
Mailing Address - Phone:612-756-9107
Mailing Address - Fax:612-235-3398
Practice Address - Street 1:4301 HIGHWAY 7 STE 200
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-5808
Practice Address - Country:US
Practice Address - Phone:612-756-9107
Practice Address - Fax:612-235-3398
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician