Individual
GORDON S NISHIMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
10821 19TH AVE SE STE 201, EVERETT, WA 98208-5103
(425) 337-7000
(425) 338-2408
Mailing address
1100 PACIFIC AVE STE 300, EVERETT, WA 98201-4261
(425) 337-7000
(425) 338-2488
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO00000725
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1036258
—
WA
Enumeration date
08/24/2005
Last updated
03/31/2025
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