Provider Demographics
NPI:1699727271
Name:TOWNSEND, GORDON LEROY (DC)
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:LEROY
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10063
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98909-1063
Mailing Address - Country:US
Mailing Address - Phone:099-022-7635
Mailing Address - Fax:509-453-1453
Practice Address - Street 1:107 S 7TH AVE STE 203
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3385
Practice Address - Country:US
Practice Address - Phone:506-902-2763
Practice Address - Fax:509-453-1453
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00000744111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor