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
Phone: (253) 627-4930
Fax: (253) 627-4649
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760417554 | NPPES |
| Other | 50106 | L&I | |
| MEDICAID | 1030766 | L&I | |
| Other | GO6295 | L&I |
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