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NPI Code Detail

MEDICARE: GORDON F.F. FALL M.D.

MEDICARE: GORDON F.F. FALL M.D.
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
1207Q00000XFamily Medicine PhysicianMD00009179WA

Other Identifiers

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

General Provider Information

NPI Number : 1538141858
Entity Type Code : Individual
Provider Name (Legal Business Name) : GORDON F.F. FALL M.D.
Provider Business Mailing Address
First Line : 7715 24TH AVE NW
Second Line :
City : SEATTLE
State : WA
Zip : 98117-4412
Country : US
Telephone Number : 206-782-1133
Fax Number : 206-782-1373
Provider Business Practice Location Address
First Line : 7715 24TH AVE NW
Second Line :
City : SEATTLE
State : WA
Zip : 98117-4412
Country : US
Telephone Number : 206-782-1133
Fax Number : 206-782-1373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2005
Last Update Date : 07/09/2007

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