Individual
LISA BARBARA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
8301 161ST AVE NE STE 208, REDMOND, WA 98052-3858
(425) 882-4347
Mailing address
4259 WOODLAND PARK AVE N APT 3, SEATTLE, WA 98103-7449
(708) 476-0265
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60981400
WA
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL60981400
SPEECH LANGUAGE PATHOLOGIST LICENSE
WA
01
—
SI60891300
INTERIM PERMIT
WA
Enumeration date
06/14/2019
Last updated
11/27/2023
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