Individual provider · Type 1 NPI
Gordon Ray Washington, PA
Medical Physician Assistant · Cp Red Cloud, KR
NPI number
1205990504
Active
Practice location
Hhsc Stb, Unit #15110
Cp Red Cloud, KR APO AP 96258
Mailing address
723 Daffodil St
Fountain, CO 80817-4174
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 1034659 (CO) |
Medical Physician Assistant: Definition to come...
About NPI 1205990504
Gordon Ray Washington, PA's National Provider Identifier is 1205990504, issued on Dec 20, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Cp Red Cloud, KR. The record was last updated on Jul 8, 2007.