Active NPI
John G Gordon, RPH
- Pharmacist
- Granite Falls, WA
National Provider Identifier
1538145180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH15083
- Practice address
- 115 N Granite Ave
Granite Falls, WA 98252-2348 - Phone
- (360) 691-7778
- Fax
- (360) 691-4458
- NPI assigned
- Dec 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH15083 | WA | Primary |
Addresses
Primary practice location
115 N Granite Ave
Granite Falls, WA 98252-2348
Mailing address
2101 Rainier Ave
Everett, WA 98201-2434
Phone (425) 252-7493
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH15083 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1538145180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 RAINIER AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982012434",
"telephone_number": "425-252-7493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 N GRANITE AVE",
"city": "GRANITE FALLS",
"state": "WA",
"postal_code": "982522348",
"telephone_number": "360-691-7778",
"fax_number": "360-691-4458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "JOHN",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-15",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH15083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granite Falls, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.