Provider Demographics
NPI:1518472349
Name:GORDON, RACHEL DIANE (LMHC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DIANE
Last Name:GORDON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13741 15TH AVE NE APT C6
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3124
Mailing Address - Country:US
Mailing Address - Phone:206-548-3058
Mailing Address - Fax:206-752-5758
Practice Address - Street 1:13741 15TH AVE NE APT C6
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-3124
Practice Address - Country:US
Practice Address - Phone:206-672-8075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60747138101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health