Individual
TISHA C. GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
170 N 1100 E, AMERICAN FORK, UT 84003-2096
(801) 763-3300
(801) 432-2668
Mailing address
10150 CENTENNIAL PKWY, SUITE 230, SANDY, UT 84070-4103
(801) 432-2600
(801) 432-2668
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
354490-4406
UT
Other
Enumeration date
02/09/2010
Last updated
02/09/2010
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