Individual
SUZANNAH GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 E SPENCER LAKE RD, SHELTON, WA 98584-7307
(360) 426-8292
Mailing address
3165 17TH ST, BOULDER, CO 80304-2617
(703) 304-7821
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0006155
CO
225X00000X
Occupational Therapist
Primary
61459349
WA
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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