Individual
KIM GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
81 S KEEL WAY, PORT LUDLOW, WA 98365-9542
(425) 894-4494
Mailing address
81 S KEEL WAY, PORT LUDLOW, WA 98365-9542
(425) 894-4494
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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