Gonzales, Bernadeth Tagle
Gonzales, Bernadeth Tagle is an individual health care provider with primary practice located at 1909 214Th St Se Ste 300 , Bothell WA 98021-4418. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Gonzales, Bernadeth Tagle can be contacted via phone (425) 412-7200.Contact Information
Primary practice address
1909 214Th St Se Ste 300
Bothell WA 98021-4418
Phone: (425) 412-7200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD00047444 | Washington |
Profile Details
| NPI number | 1104869429 |
|---|---|
| LBN Legal business name | Gonzales, Bernadeth Tagle |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Jun 28th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104869429 | NPPES |
| Washington | Other | 225508 | L & I NUMBER |
| Washington | Other | 8868622 | L & I NUMBER |
| Washington | MEDICAID | 1042878 | L & I NUMBER |
| Washington | MEDICAID | 8495723 | L & I NUMBER |
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