David M. Gordon, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60644369 Issued in WA

Practice address

930 N Broadway
Everett, WA 98201-1409

Phone

(425) 317-0300

NPI assigned

Dec 8, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1730136367

  Family Medicine

  Medicare reassignment NPD
• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1023830346
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1457410110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 153RD PL SW",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980264435",
            "telephone_number": "425-583-4819",
            "fax_number": "425-595-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 N BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011409",
            "telephone_number": "425-317-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DAVID",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G42527",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60644369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2067764",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gordon B Davis MD DDS PS
• Katherynn E. Gordon-Sawiris, LCSW
• Andrea Jean Gordon
• Catia Gordon
• Chelsea Rae Holzinger Gordon, N.D.
• Gavin Gordon, MD
• Katelynn Marie Gordon, PT, DPT
• Patrick Michael Gorman, SUDP TRAINEE
• Divine Grace Gorospe, ARNP
• Tiffany D Gorski, MSW

• Family Medicine Physician in Everett, WA
• Providers in Everett, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.