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General NPI Number Information
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NPI Number | 1497985899
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Entity Type | Individual
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Provider Name | VIOLETA MERCEDES GOMEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 07/02/2024
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Provider Practice Location Address
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Address Line | 19540 FRONT ST NE
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City | POULSBO
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State | WA
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Zip | 98370-7316
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Country | US
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Telephone | 564-218-6135
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Fax |
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Provider Business Mailing Address
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Address Line | 2341 NE WINLOCK WAY
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City | POULSBO
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State | WA
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Zip | 98370-9258
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Country | US
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Telephone | 470-733-0321
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Fax | 678-377-9390
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 60912725
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License Number State | WA
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