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NPI Code Detail

MEDICARE: KATHRYN GORDON OTR/L

MEDICARE: KATHRYN GORDON OTR/L
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
1225X00000XOccupational TherapistOT00003225WA

General Provider Information

NPI Number : 1356692107
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN GORDON OTR/L
Provider Business Mailing Address
First Line : 13007 NE GLISAN ST
Second Line :
City : PORTLAND
State : OR
Zip : 97230-2545
Country : US
Telephone Number : 503-215-3455
Fax Number : 503-215-7864
Provider Business Practice Location Address
First Line : 13007 NE GLISAN ST
Second Line :
City : PORTLAND
State : OR
Zip : 97230-2545
Country : US
Telephone Number : 503-215-3455
Fax Number : 503-215-7864
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2012
Last Update Date : 01/21/2026

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Directions to “ KATHRYN GORDON OTR/L” Practice Location

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