Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | MD00026686 | WA |
N | 207Q00000X | Family Doctor | MD00026686 | WA |
NPI | 1285881441 |
---|---|
Provider Name | Dr. Brian O Goertz |
First Address | Kirkland, WA 98033-4605 |
Second Address | Kirkland, WA 98033-4605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 12/08/2011 |