Nishimoto, Gordon S

Nishimoto, Gordon S is an sole proprietor health care provider with primary practice located at 10821 19Th Ave Se Ste 201 , Everett WA 98208-5103. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Nishimoto, Gordon S can be contacted via phone (425) 337-7000.

Contact Information

Primary practice address
10821 19Th Ave Se Ste 201 Everett WA 98208-5103
Phone: (425) 337-7000
Fax: (425) 338-2408
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X PO00000725 Washington

Profile Details

NPI number 1356334460
LBN Legal business name Nishimoto, Gordon S
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2005
Last updated Dec 3rd, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356334460 NPPES
Washington MEDICAID 8484396

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