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General NPI Number Information
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NPI Number | 1326063637
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Entity Type | Individual
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Provider Name | DAVID G GORMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 12/03/2010
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Provider Practice Location Address
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Address Line | 1135 116TH AVE NE SUITE 200
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City | BELLEVUE
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State | WA
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Zip | 98004-4623
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Country | US
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Telephone | 425-709-7055
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Fax | 428-709-7066
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Provider Business Mailing Address
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Address Line | PO BOX 94568
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City | SEATTLE
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State | WA
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Zip | 98124-6868
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Country | US
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Telephone | 888-846-5527
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Fax | 607-324-2369
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MD00042040
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD00037143
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License Number State | WA
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