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NPI Code Detail

MEDICARE: DEBRA A GOULD M.D.

MEDICARE:   DEBRA A GOULD  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 PhysicianMD00027853WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P00059088OTHERWARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28939873OTHERWACRIME VICTIM
30107394OTHERWALABOR & INDUSTRIES

General Provider Information

NPI Number : 1740289883
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA A GOULD M.D.
Provider Business Mailing Address
First Line : 3800 SUMMITVIEW AVE
Second Line :
City : YAKIMA
State : WA
Zip : 98902-2715
Country : US
Telephone Number : 509-248-7849
Fax Number : 509-248-8291
Provider Business Practice Location Address
First Line : 504 N 40TH AVE
Second Line :
City : YAKIMA
State : WA
Zip : 98908-4311
Country : US
Telephone Number : 509-966-9480
Fax Number : 509-225-2702
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 02/20/2024

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Directions to “ DEBRA A GOULD M.D.” Practice Location

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