Healthcare Provider Details

I. General information

NPI: 1548241029
Provider Name (Legal Business Name): GORDON HENRY HSIEH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 SWIFT BLVD
RICHLAND WA
99352
US

IV. Provider business mailing address

560 GAGE BLVD SUITE 203
RICHLAND WA
99352
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-1654
  • Fax: 509-943-5652
Mailing address:
  • Phone: 509-942-3627
  • Fax: 509-942-2268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOP00001199
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: