Healthcare Provider Details

I. General information

NPI: 1285604892
Provider Name (Legal Business Name): JUNE S GOLDMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 03/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5952 BLACKSTONE WAY LAKE SPOKANE COMMUNITY HEALTH CENTER
NINE MILE FALLS WA
99026-4900
US

IV. Provider business mailing address

5952 BLACKSTONE WAY LAKE SPOKANE COMMUNITY HEALTH CENTER
NINE MILE FALLS WA
99026-4900
US

V. Phone/Fax

Practice location:
  • Phone: 509-464-3627
  • Fax: 509-466-9517
Mailing address:
  • Phone: 509-464-3627
  • Fax: 509-466-9517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00020871
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: