Mateo, Godofredo L
Mateo, Godofredo L is an individual health care provider with primary practice located at 7226 Interlaaken Dr Sw , Lakewood WA 98499-1800. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Mateo, Godofredo L can be contacted via phone (253) 588-4866.Contact Information
Primary practice address
7226 Interlaaken Dr Sw
Lakewood WA 98499-1800
Phone: (253) 588-4866
Fax: (253) 588-4866
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | MD00012743 | Washington |
Profile Details
| NPI number | 1912059122 |
|---|---|
| LBN Legal business name | Mateo, Godofredo L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 17th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912059122 | NPPES |
| Washington | MEDICAID | 1100387 |
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