Individual
MISS TINA T GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
104 W 5TH AVE, SUITE 205E, SPOKANE, WA 99204-4880
(509) 939-9722
Mailing address
PO BOX 8626, SPOKANE, WA 99203-0626
(509) 939-9722
(509) 228-9542
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN00106322
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9624115
—
WA
Enumeration date
06/26/2006
Last updated
07/08/2007
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