MEDICARE: DR. ROBERT C GOODE MD

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
1	207Q00000X	Family Medicine Physician	MD00033004	WA

General Provider Information

NPI Number	:	1356415707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT C GOODE MD

Provider Business Mailing Address
First Line	:	8015 SE 28TH ST
Second Line	:	SUITE 310
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2910
Country	:	US
Telephone Number	:	206-898-2416
Fax Number	:	877-771-1073

Provider Business Practice Location Address
First Line	:	8015 SE 28TH ST
Second Line	:	SUITE 310
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2910
Country	:	US
Telephone Number	:	206-898-2416
Fax Number	:	877-771-1073

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	02/04/2016

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