Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD00031624 | WA |
N | 111NI0900X | Internist | MD00031624 | WA |
N | 207RA0401X | Internist - Addiction Medicine | MD00031624 | WA |
Y | 207RS0012X | Sleep Medicine | MD00031624 | WA |
NPI | 1497725998 |
---|---|
Provider Name | Dr. Sophie Gomez |
First Address | Yakima, WA 98902-1576 |
Second Address | Richland, WA 99352-4720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 28/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0202009 | L&I (01) | WA |
077333500 | OWCP FECA (01) | WA |
8184913 | (05) | WA |
E21929 | (02) | WA |