Healthcare Provider Details

I. General information

NPI: 1801208616
Provider Name (Legal Business Name): LAUREN GOLI MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 16TH AVE STE 100
SEATTLE WA
98122-5636
US

IV. Provider business mailing address

550 16TH AVE STE 100
SEATTLE WA
98122-5636
US

V. Phone/Fax

Practice location:
  • Phone: 206-762-3730
  • Fax:
Mailing address:
  • Phone: 206-762-3730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberML 60471480
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: