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NPI Code Detail

MEDICARE: JEFFREY ALAN GOLD MSW., PH.D.

MEDICARE:   JEFFREY ALAN GOLD  MSW., PH.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
11041C0700XClinical Social WorkerLW00005010WA

General Provider Information

NPI Number : 1598904104
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY ALAN GOLD MSW., PH.D.
Provider Business Mailing Address
First Line : 1817 QUEEN ANNE AVE N
Second Line : SUITE 416
City : SEATTLE
State : WA
Zip : 98109-2876
Country : US
Telephone Number : 206-201-1154
Fax Number :
Provider Business Practice Location Address
First Line : 1817 QUEEN ANNE AVE N
Second Line : SUITE 416
City : SEATTLE
State : WA
Zip : 98109-2876
Country : US
Telephone Number : 206-201-1154
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2009
Last Update Date : 06/08/2012

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Directions to “ JEFFREY ALAN GOLD MSW., PH.D.” Practice Location

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