Active NPI
Lisa Barbara Gordon, M.S.
- Speech-Language Pathologist
- Redmond, WA
National Provider Identifier
1154981967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL60981400
- Practice address
- 8301 161St Ave NE Ste 208
Redmond, WA 98052-3858 - Phone
- (425) 882-4347
- NPI assigned
- Jun 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | |||
| Speech-Language Pathologist | 235Z00000X | LL60981400 | WA | Primary |
Addresses
Primary practice location
8301 161St Ave NE Ste 208
Redmond, WA 98052-3858
Mailing address
4259 Woodland Park Ave N Apt 3
Seattle, WA 98103-7449
Phone (708) 476-0265
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SI60891300 | Other | WA | INTERIM PERMIT |
| LL60981400 | Other | WA | SPEECH LANGUAGE PATHOLOGIST LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lgordon@lwsd.org | Lake Washington School District |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1154981967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4259 WOODLAND PARK AVE N APT 3",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981037449",
"telephone_number": "708-476-0265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8301 161ST AVE NE STE 208",
"city": "REDMOND",
"state": "WA",
"postal_code": "980523858",
"telephone_number": "425-882-4347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "LISA",
"middle_name": "BARBARA",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-14",
"last_updated": "2023-11-27",
"certification_date": "2020-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL60981400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERIM PERMIT",
"identifier": "SI60891300",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH LANGUAGE PATHOLOGIST LICENSE",
"identifier": "LL60981400",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lgordon@lwsd.org",
"affiliation": "Y",
"endpointDescription": "Secure email",
"affiliationName": "Lake Washington School District",
"address_1": "8301 161st Ave NE Ste 208",
"city": "Redmond",
"state": "WA",
"country_code": "US",
"postal_code": "980523858",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Redmond, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.