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General NPI Number Information
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NPI Number | 1164786083
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Entity Type | Individual
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Provider Name | JOSHUA BRANDON GOLDSTEIN FNP
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Gender | Male
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 14406 NE 20TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98686-1448
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Country | US
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Telephone | 360-418-6001
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Fax | 360-571-3118
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Provider Business Mailing Address
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Address Line | 14104 NW 10TH CT
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City | VANCOUVER
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State | WA
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Zip | 98685-1700
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Country | US
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Telephone | 360-909-8445
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 200741480RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN60186140
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60460572
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License Number State | WA
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