Goldman, Jack

Goldman, Jack is an sole proprietor health care provider with primary practice located at 101 2Nd St Ne , Auburn WA 98002-4902. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Goldman, Jack can be contacted via phone (253) 833-3650.

Contact Information

Primary practice address
101 2Nd St Ne Auburn WA 98002-4902
Phone: (253) 833-3650
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD00017877 Washington
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD00017877 Washington

Profile Details

NPI number 1023065539
LBN Legal business name Goldman, Jack
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 28th, 2006
Last updated Mar 27th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023065539 NPPES
Washington MEDICAID 1730100

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