Provider Demographics
NPI:1932698230
Name:GORDON, EMMA JANE (MA MTH)
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:JANE
Last Name:GORDON
Suffix:
Gender:F
Credentials:MA MTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6788 138TH AVE NE APT 625
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-9562
Mailing Address - Country:US
Mailing Address - Phone:206-617-1347
Mailing Address - Fax:
Practice Address - Street 1:1331 118TH AVE SE STE 400
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3873
Practice Address - Country:US
Practice Address - Phone:425-644-0988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist