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Grant Gordon

Student in an Organized Health Care Education/Training Program in Glendale, AZ. Individual provider (NPI-1).

NPI number1386584431
StatusActive
Last updated in NPPESMar 30, 2026

Details

NPI
1386584431
Entity type
Individual (NPI-1)
Name
Grant Gordon
Sex
Male
Sole proprietor
No
Enumeration date
Mar 30, 2026
Certification date
Mar 30, 2026
Last updated
Mar 30, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

18701 N 67th Ave
Glendale, AZ 85308-7100

Phone 623-561-1000

Mailing address

16601 N 75th Ave Unit 3052
Peoria, AZ 85382-5034

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