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General NPI Number Information
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NPI Number | 1023167897
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Entity Type | Individual
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Provider Name | RYAN K GOULD M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 325 9TH AVE HMC 3.EC.27, BOX 359702
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City | SEATTLE
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State | WA
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Zip | 98104-2420
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Country | US
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Telephone | 206-744-2556
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Fax |
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Provider Business Mailing Address
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Address Line | 325 9TH AVE HMC 3.EC.27, BOX 359702
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City | SEATTLE
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State | WA
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Zip | 98104-2420
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Country | US
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Telephone | 206-744-2556
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A101036
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD 60484309
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License Number State | WA
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