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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KIM GORDON

Active Sole Proprietor

KIM GORDON is a Podiatric Surgery healthcare provider located in PORT LUDLOW, Washington. NPI 1578111506 is currently active in the NPPES registry. Verify at CMS.

Podiatric Surgery · PORT LUDLOW, WA

Registration Details

NPI Number
1578111506
Provider Type
Individual
Gender
Female
NPI Issued
Sep 3, 2019 (6.7669808860403 yrs)
Last Updated
Sep 3, 2019
Sole Proprietor
Yes

Practice Information

Address
81 S KEEL WAY
PORT LUDLOW, WA, 983659542
Browse WA providers · Browse ZIP 98365
Phone
4258944494
Primary Specialty
Podiatric Surgery
3747A0650X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.