Individual
MIRANDA J GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
800 WEST MAPLE STREET, MEDICAL LAKE, WA 99022-0800
(509) 299-3121
(509) 299-7015
Mailing address
800 WEST MAPLE STREET, MEDICAL LAKE, WA 99022-0800
(509) 299-3121
(509) 299-7015
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00003212
WA
Other
Enumeration date
06/10/2008
Last updated
06/10/2008
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