Goldworm, Brad

Goldworm, Brad is an individual health care provider with primary practice located at 2950 Limited Ln Nw , Olympia WA 98502-4577. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Goldworm, Brad can be contacted via phone (360) 252-9777.

Contact Information

Primary practice address
2950 Limited Ln Nw Olympia WA 98502-4577
Phone: (360) 252-9777
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA10004755 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA10004755 Washington

Profile Details

NPI number 1295889087
LBN Legal business name Goldworm, Brad
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated Jan 7th, 2021 - about 3 years ago

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 1295889087 NPPES
Washington MEDICAID 8446841

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