MEDICARE: JAMES GORDON MD, FRCPC, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084H0002X	Hospice and Palliative Medicine (Psychiatry & Neurology) Physician	33598	WA
2	2084N0400X	Neurology Physician	33598	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205871241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES GORDON MD, FRCPC, PLLC

Provider Business Mailing Address
First Line	:	1536 N 115TH ST
Second Line	:	SUITE 330
City	:	SEATTLE
State	:	WA
Zip	:	98133-8400
Country	:	US
Telephone Number	:	206-365-0111
Fax Number	:	206-365-2980

Provider Business Practice Location Address
First Line	:	1536 N 115TH ST
Second Line	:	SUITE 330
City	:	SEATTLE
State	:	WA
Zip	:	98133-8400
Country	:	US
Telephone Number	:	206-365-0111
Fax Number	:	206-365-2980

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	06/20/2016

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