Gordon, Michael Jeffrey

Gordon, Michael Jeffrey is an individual health care provider with primary practice located at 1717 S J St , Tacoma WA 98405-4933. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Gordon, Michael Jeffrey can be contacted via phone (253) 627-4930.

Contact Information

Primary practice address
1717 S J St Tacoma WA 98405-4933
Fax: (253) 627-4649
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD00016377 Washington

Profile Details

NPI number 1760417554
LBN Legal business name Gordon, Michael Jeffrey
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760417554 NPPES
Other 50106 L&I
MEDICAID 1030766 L&I
Other GO6295 L&I

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