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NPI Code Detail

MEDICARE: DR. JUNE S GOLDMAN M.D.

MEDICARE: DR. JUNE S GOLDMAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD00020871WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080010938OTHERWARR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
223020OTHERWAL&I
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285604892
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUNE S GOLDMAN M.D.
Provider Business Mailing Address
First Line : 5952 BLACKSTONE WAY
Second Line : LAKE SPOKANE COMMUNITY HEALTH CENTER
City : NINE MILE FALLS
State : WA
Zip : 99026-4900
Country : US
Telephone Number : 509-464-3627
Fax Number : 509-466-9517
Provider Business Practice Location Address
First Line : 5952 BLACKSTONE WAY
Second Line : LAKE SPOKANE COMMUNITY HEALTH CENTER
City : NINE MILE FALLS
State : WA
Zip : 99026-4900
Country : US
Telephone Number : 509-464-3627
Fax Number : 509-466-9517
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 03/31/2009

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