Provider Demographics
NPI:1306854641
Name:ARNOTT, GORDON M (MD)
Entity Type:Individual
Prefix:
First Name:GORDON
Middle Name:M
Last Name:ARNOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1319 NE 134TH ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685
Mailing Address - Country:US
Mailing Address - Phone:360-566-4700
Mailing Address - Fax:360-566-4739
Practice Address - Street 1:1319 NE 134TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685
Practice Address - Country:US
Practice Address - Phone:360-566-4700
Practice Address - Fax:360-566-4739
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00038000174400000X, 207Q00000X
CODR.0067968207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8851724Medicaid
WA8413312Medicaid
WAG8851724Medicaid
WA8851724Medicare PIN