Healthcare Provider Details

I. General information

NPI: 1194511592
Provider Name (Legal Business Name): DARIO GONZALEZ HERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST BOX 356540
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

1959 NE PACIFIC ST BOX 356540
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-2474
  • Fax:
Mailing address:
  • Phone: 206-543-2474
  • Fax: 206-543-2958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMDRE.ML.70112812
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: