Gorham, Jay R

Gorham, Jay R is an individual health care provider with primary practice located at 1201 S Miller St Ste A , Wenatchee WA 98801-3201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Gorham, Jay R can be contacted via phone (509) 663-8711.

Contact Information

Primary practice address
1201 S Miller St Ste A Wenatchee WA 98801-3201
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD00018552 Washington

Profile Details

NPI number 1801827753
LBN Legal business name Gorham, Jay R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Jul 14th, 2015 - about 9 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 1801827753 NPPES
Washington Other 315806 WVH LNI
Washington Other P01211966 WVH LNI
Washington MEDICAID 1801827753 WVH LNI

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