Healthcare Provider Details

I. General information

NPI: 1366451825
Provider Name (Legal Business Name): RICHARD E GILBERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 03/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3124 S 19TH ST STE 110
TACOMA WA
98405-2433
US

IV. Provider business mailing address

3124 S 19TH ST STE 110
TACOMA WA
98405-2433
US

V. Phone/Fax

Practice location:
  • Phone: 253-459-7500
  • Fax:
Mailing address:
  • Phone: 253-459-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00011985
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD00011985
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code2083T0002X
TaxonomyMedical Toxicology (Preventive Medicine) Physician
License NumberMD00011985
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberMD00011985
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberMD00011985
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: