Individual
JACALYN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
323 E 6TH ST, PORT ANGELES, WA 98362-6203
(360) 457-8355
Mailing address
PO BOX 868, PORT ANGELES, WA 98362-0159
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
00124844
WA
Other
Enumeration date
06/09/2017
Last updated
06/09/2017
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