Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | MD00019476 | WA |
NPI | 1255402251 |
---|---|
Provider Name | Gary E. Goodman |
First Address | Seattle, WA 98124-8426 |
Second Address | Seattle, WA 98104-3588 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 25/05/2021 |