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Individual

JANET I GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7017 NE HWY 99, SUITE 201, VANCOUVER, WA 98665
(360) 694-0760
(360) 694-1091
Mailing address
7017 NE HIGHWAY 99, SUITE 202, VANCOUVER, WA 98665-0555
(360) 694-0760
(360) 694-1091

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0017326
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0615108
ALL OTHER INS
WA
05
1025675
WA
01
83020001
SECURE HOR PACIFICARE
WA
Enumeration date
04/06/2006
Last updated
07/10/2008
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