LOUISSA CAROLYN GORDON

BOISE, ID
NPI1821484452
Former NameLOUISSA C SAUTER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-1772)
Additional Taxonomies363A00000X Physician Assistant
(Licence: WA  PA60549072)
Enumeration Date2015-04-10
Last Update Date2019-08-22
Business Address
LOUISSA CAROLYN GORDON PA-C
121 E FORT ST
BOISE, ID 83712-6322
Phone number: 208-514-2525
Mailing Address
LOUISSA CAROLYN GORDON PA-C
777 N RAYMOND ST
BOISE, ID 83704-9251
Phone number: 208-514-2500