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Individual
SHELBY MAE GORDON
Active
Individual
SHELBY MAE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60975819
WA
225100000X
Physical Therapist
PT6206
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113
—
WA
Enumeration date
10/21/2019
Last updated
10/14/2022
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