Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gordon S Nishimoto, DPM

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1356334460

Gordon S Nishimoto, DPM is a Podiatry in Everett, Washington. Graduated from California School of Podiatric Medicine in 1998, 28 years ago. Practices with Proliance Surgeons Inc P S, a 394-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
28
Trained at
California School of Podiatric Medicine
Licensed in
WA
In the registry since
2005
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

10821 19th Ave SE Ste 201
Everett, WA 98208-5103
Phone: (425) 337-7000
Fax: (425) 338-2408
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence PO00000725 (WA)

Record details

NPI number1356334460
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedAugust 24, 2005
Last updated in NPPESMarch 31, 2025
Certification dateMarch 31, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolCALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduated 1998 (28 years in practice)
Group practice Proliance Surgeons Inc P S — 394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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