Provider Demographics
NPI:1992443873
Name:GORDON, AMBER (DNP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:GORDON
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
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Mailing Address - Street 1:109 W 27TH ST RM 5S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6208
Mailing Address - Country:US
Mailing Address - Phone:833-351-8255
Mailing Address - Fax:888-815-3583
Practice Address - Street 1:400 UNION AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-2060
Practice Address - Country:US
Practice Address - Phone:833-351-8255
Practice Address - Fax:888-815-3583
Is Sole Proprietor?:No
Enumeration Date:2022-05-21
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ285329363LP0808X
OR10017042363LP0808X
TN30774363LP0808X
WAAP61684710363LP0808X
IAG172246363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health