Provider Demographics
NPI:1427627520
Name:GRAVES, GORDON JAMES (VOC REHAB SPECIALIST)
Entity type:Individual
Prefix:MR
First Name:GORDON
Middle Name:JAMES
Last Name:GRAVES
Suffix:
Gender:M
Credentials:VOC REHAB SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6820 N FOX POINT DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4224
Mailing Address - Country:US
Mailing Address - Phone:509-405-1784
Mailing Address - Fax:
Practice Address - Street 1:504 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1406
Practice Address - Country:US
Practice Address - Phone:509-462-2500
Practice Address - Fax:509-462-2503
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator