Healthcare Provider Details

I. General information

NPI: 1932014487
Provider Name (Legal Business Name): CAROLINE E GOLEC DPT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10004 204TH AVE E STE 3100
BONNEY LAKE WA
98391-6540
US

IV. Provider business mailing address

4301 S PINE ST
TACOMA WA
98409-7264
US

V. Phone/Fax

Practice location:
  • Phone: 253-987-7509
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: