SearchIdaho363A00000X

Louissa Gordon, PA-C

NPI 1821484452 · on the registry since 2015

Practice

Address
121 E Fort St
Boise, ID 83712
Phone
(208) 514-2525
Fax
(208) 375-2217
Clinicians at this address
3

Registry record

Primary taxonomy
363A00000X
363A00000X
Also registered as
363A00000X
Licence states on file
WA, ID
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2019-08-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho